Provider Demographics
NPI:1215661087
Name:CAMPBELL, KYLIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:KYLIE
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 VOORHEES TOWN CTR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1910
Mailing Address - Country:US
Mailing Address - Phone:856-346-0005
Mailing Address - Fax:800-691-4185
Practice Address - Street 1:2050 VOORHEES TOWN CTR
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1910
Practice Address - Country:US
Practice Address - Phone:856-346-0005
Practice Address - Fax:800-691-4185
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00793800103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist