Provider Demographics
NPI:1477815116
Name:CAMPBELL, YOSEFIAH (MS)
Entity Type:Individual
Prefix:MS
First Name:YOSEFIAH
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17220 133RD AVE APT 13A
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3969
Mailing Address - Country:US
Mailing Address - Phone:347-605-9949
Mailing Address - Fax:
Practice Address - Street 1:17220 133RD AVE APT 13A
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3969
Practice Address - Country:US
Practice Address - Phone:347-605-9949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor