Provider Demographics
NPI:1275210833
Name:CAMPBELL, CORI LYNN (RBT)
Entity Type:Individual
Prefix:
First Name:CORI
Middle Name:LYNN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 OAK MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1324
Mailing Address - Country:US
Mailing Address - Phone:205-358-7311
Mailing Address - Fax:
Practice Address - Street 1:1051 OAK MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1324
Practice Address - Country:US
Practice Address - Phone:205-358-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician