Provider Demographics
NPI:1669416061
Name:CAMPBELL, MICHELLE DANIELLE
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:DANIELLE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:CHRISTIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 SWEDESBORO RD
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-1800
Mailing Address - Country:US
Mailing Address - Phone:856-478-0501
Mailing Address - Fax:856-478-0567
Practice Address - Street 1:108 SWEDESBORO RD
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-1800
Practice Address - Country:US
Practice Address - Phone:856-478-0501
Practice Address - Fax:856-478-0567
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMG00001009237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist