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NPI Code Detail

MEDICARE: ALISHA RENEE CAMPBELL

MEDICARE: ALISHA RENEE CAMPBELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.164147OH

General Provider Information

NPI Number : 1225526338
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISHA RENEE CAMPBELL
Provider Business Mailing Address
First Line : 110 HIGHLAND AVE
Second Line :
City : CIRCLEVILLE
State : OH
Zip : 43113-1208
Country : US
Telephone Number : 740-477-1745
Fax Number :
Provider Business Practice Location Address
First Line : 780 GREGG ST
Second Line :
City : WASHINGTON COURT HOUSE
State : OH
Zip : 43160-1564
Country : US
Telephone Number : 740-313-7513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2018
Last Update Date : 04/24/2018

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Directions to “ ALISHA RENEE CAMPBELL ” Practice Location

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