Provider Demographics
NPI:1295048346
Name:CAMPBELL, MARGIE JACLYN (MS)
Entity type:Individual
Prefix:
First Name:MARGIE
Middle Name:JACLYN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 TUMBLEWEED ST NE
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-8522
Mailing Address - Country:US
Mailing Address - Phone:330-618-5231
Mailing Address - Fax:
Practice Address - Street 1:2285 BENDEN DR
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2568
Practice Address - Country:US
Practice Address - Phone:330-264-9029
Practice Address - Fax:330-263-7251
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health