Provider Demographics
NPI:1396880696
Name:CAMPBELL, MARY JANE (MS RN LMFT LMHC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:JANE
Last Name:CAMPBELL
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Gender:F
Credentials:MS RN LMFT LMHC
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Mailing Address - Street 1:421 WEST RIVERSIDE AVENUE
Mailing Address - Street 2:SUITE 602
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201
Mailing Address - Country:US
Mailing Address - Phone:509-455-7878
Mailing Address - Fax:509-455-7005
Practice Address - Street 1:421 WEST RIVERSIDE AVENUE
Practice Address - Street 2:SUITE 602
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201
Practice Address - Country:US
Practice Address - Phone:509-455-7878
Practice Address - Fax:509-455-7005
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
WALH00005088 LMHC101YM0800X
WALF00001280 LMFT106H00000X
WARN00075016163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered163W00000XNursing Service ProvidersRegistered Nurse