Provider Demographics
NPI:1245894484
Name:CAMPBELL, MARIE KATHARINE
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:KATHARINE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LA FORET DR
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-3817
Mailing Address - Country:US
Mailing Address - Phone:530-282-8911
Mailing Address - Fax:
Practice Address - Street 1:3217 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-5404
Practice Address - Country:US
Practice Address - Phone:530-891-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)