Individual
AMY MARIE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1234 EMPIRE ST STE 1500, FAIRFIELD, CA 94533-5711
(707) 426-4746
Mailing address
1234 EMPIRE ST STE 1500, FAIRFIELD, CA 94533-5711
(707) 426-4746
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
ASW73979
CA
1041C0700X
Clinical Social Worker
Primary
LCSW104591
CA
Other
Enumeration date
02/25/2011
Last updated
10/19/2021
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