Provider Demographics
NPI:1083303325
Name:CAMPOPIANO, HAYLEE DAWN
Entity Type:Individual
Prefix:
First Name:HAYLEE
Middle Name:DAWN
Last Name:CAMPOPIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HAYLEE
Other - Middle Name:
Other - Last Name:MCCANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 OLD SOUTH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-4120
Mailing Address - Country:US
Mailing Address - Phone:636-224-1210
Mailing Address - Fax:636-246-1008
Practice Address - Street 1:1204 S AURORA ST
Practice Address - Street 2:
Practice Address - City:ELDON
Practice Address - State:MO
Practice Address - Zip Code:65026-1620
Practice Address - Country:US
Practice Address - Phone:573-557-2396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023015682101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional