Healthcare Provider Details

I. General information

NPI: 1437920964
Provider Name (Legal Business Name): CASSANDRA CAMPEAN CD, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11806 NEW BUFFALO RD
NORTH LIMA OH
44452-9517
US

IV. Provider business mailing address

11806 NEW BUFFALO RD
NORTH LIMA OH
44452-9517
US

V. Phone/Fax

Practice location:
  • Phone: 330-503-8208
  • Fax:
Mailing address:
  • Phone: 330-503-8208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number1909
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: