Provider Demographics
NPI:1780868240
Name:CAMPBELL, DEBBIE L (MA)
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:L
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 DEER LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-1218
Mailing Address - Country:US
Mailing Address - Phone:502-802-9322
Mailing Address - Fax:
Practice Address - Street 1:1732 DEER LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1218
Practice Address - Country:US
Practice Address - Phone:502-802-9322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging