Provider Demographics
NPI:1235285578
Name:CAMPBELL, NATALIE SIPE (MS CCC-SLPE)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:SIPE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS CCC-SLPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3165 SENTINEL PKWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-2193
Mailing Address - Country:US
Mailing Address - Phone:404-751-7757
Mailing Address - Fax:
Practice Address - Street 1:3165 SENTINEL PKWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-2193
Practice Address - Country:US
Practice Address - Phone:404-751-7757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006274235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist