Provider Demographics
NPI:1568653459
Name:CAMPBELL, SHAWNA YVETTE (SOCIAL WORKER)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:YVETTE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 SANDPIPER DR
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-1929
Mailing Address - Country:US
Mailing Address - Phone:713-240-6311
Mailing Address - Fax:832-217-3142
Practice Address - Street 1:3100 SANDPIPER DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-1929
Practice Address - Country:US
Practice Address - Phone:713-240-6311
Practice Address - Fax:832-217-3142
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28071171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator