Provider Demographics
NPI:1700969953
Name:CAMPBELL, LISA (PHD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DUKE UNIVERSITY MEDICAL CTR
Mailing Address - Street 2:DUMC 90399
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27708-0001
Mailing Address - Country:US
Mailing Address - Phone:919-684-8111
Mailing Address - Fax:
Practice Address - Street 1:DUKE UNIVERSITY MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27708-0001
Practice Address - Country:US
Practice Address - Phone:919-684-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2983103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical