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General NPI Number Information
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NPI Number | 1023754769
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Entity Type | Individual
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Provider Name | INGRID CAMPBELL
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Gender | Female
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 05/06/2022
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Provider Practice Location Address
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Address Line | 11811 EAST FWY STE 63010
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City | HOUSTON
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State | TX
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Zip | 77029-2056
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Country | US
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Telephone | 855-284-7483
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 748465
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City | ATLANTA
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State | GA
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Zip | 30374-8465
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 73727
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License Number State | TX
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