Provider Demographics
NPI:1780021949
Name:CAMPBELL, SIMONE AKEELA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:AKEELA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4113 SW 46TH TER
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-9846
Mailing Address - Country:US
Mailing Address - Phone:352-207-7628
Mailing Address - Fax:
Practice Address - Street 1:4113 SW 46TH TER
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-9846
Practice Address - Country:US
Practice Address - Phone:352-207-7628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8310235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist