Provider Demographics
NPI:1528363199
Name:CAMPBELL, ANDREA KATE
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:KATE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 LIONS CREEK CT S
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-8626
Mailing Address - Country:US
Mailing Address - Phone:724-991-3204
Mailing Address - Fax:
Practice Address - Street 1:139 LIONS CREEK CT S
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-8626
Practice Address - Country:US
Practice Address - Phone:724-991-3204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst