| NPI | 1306146410 |
|---|---|
| Former Name | KIMBERLY ANNE CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW12950) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC11696) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2010-10-25 |