Provider Demographics
NPI:1982463832
Name:CAMPBELL, HEATHER MARIE
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MARIE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:PROF
Other - First Name:HEATHER
Other - Middle Name:MARIE
Other - Last Name:FRIZZELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MA
Mailing Address - Zip Code:01503-1606
Mailing Address - Country:US
Mailing Address - Phone:508-868-7578
Mailing Address - Fax:
Practice Address - Street 1:35 SOUTH ST
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MA
Practice Address - Zip Code:01503-1606
Practice Address - Country:US
Practice Address - Phone:508-868-7578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty