Provider Demographics
NPI:1194007914
Name:KRAUSHAAR CAMPBELL, MICHELLE LEA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LEA
Last Name:KRAUSHAAR CAMPBELL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13637 60TH ST SW
Mailing Address - Street 2:
Mailing Address - City:COKATO
Mailing Address - State:MN
Mailing Address - Zip Code:55321
Mailing Address - Country:US
Mailing Address - Phone:320-286-2922
Mailing Address - Fax:320-286-2875
Practice Address - Street 1:13637 60TH ST SW
Practice Address - Street 2:
Practice Address - City:COKATO
Practice Address - State:MN
Practice Address - Zip Code:55321
Practice Address - Country:US
Practice Address - Phone:320-286-2922
Practice Address - Fax:320-286-2875
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2063106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist