Provider Demographics
NPI:1497000616
Name:CAMPBELL, REBECKA (MS)
Entity Type:Individual
Prefix:MRS
First Name:REBECKA
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 1:229 DAYS DR
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:WV
Mailing Address - Zip Code:26601-9207
Mailing Address - Country:US
Mailing Address - Phone:681-205-1769
Mailing Address - Fax:
Practice Address - Street 1:229 DAYS DR
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:WV
Practice Address - Zip Code:26601-9207
Practice Address - Country:US
Practice Address - Phone:681-205-1769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-14
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst