Provider Demographics
NPI:1235531310
Name:CAMPBELL PALMER, CYNTHYA LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHYA
Middle Name:LYNN
Last Name:CAMPBELL PALMER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CYNTHYA
Other - Middle Name:LYNN
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2800 BROADWAY ST STE C336
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-9502
Mailing Address - Country:US
Mailing Address - Phone:281-780-5821
Mailing Address - Fax:
Practice Address - Street 1:2700 BAY AREA BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058
Practice Address - Country:US
Practice Address - Phone:281-780-5821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-21
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36806103TC0700X, 103TC0700X
IL071.008533103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent