Provider Demographics
NPI:1790791440
Name:CAMPBELL, RICHARD A (PHD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:CAMPBELL
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Gender:M
Credentials:PHD
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Mailing Address - Street 1:933 BRADBURY DR SE
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:915 VASSAR DR NE
Practice Address - Street 2:SUITE 170
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2727
Practice Address - Country:US
Practice Address - Phone:505-272-8833
Practice Address - Fax:505-272-8316
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2023-10-26
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Provider Licenses
StateLicense IDTaxonomies
NM633103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist