Provider Demographics
NPI:1669287470
Name:CAROL P CAMPBELL EDD PRIVATE PRACTICE PC
Entity type:Organization
Organization Name:CAROL P CAMPBELL EDD PRIVATE PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-666-7810
Mailing Address - Street 1:2130 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FLOURTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19031-1611
Mailing Address - Country:US
Mailing Address - Phone:267-666-7810
Mailing Address - Fax:
Practice Address - Street 1:2130 CHURCH RD
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1611
Practice Address - Country:US
Practice Address - Phone:267-666-7810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty