| NPI | 1629253414 |
|---|---|
| Former Name | CAROLE LEIGH CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SC 1327) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810003901) |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2021-12-02 |