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General NPI Number Information
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NPI Number | 1093953036
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Entity Type | Individual
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Provider Name | KIMBERLY BROWN CAMPBELL LCPC,ATR
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Gender | Female
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 235 NORTH 1ST STREET WEST ZOOTOWN ARTS COMMUNITY CENTER
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City | MISSOULA
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State | MT
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Zip | 59802-3661
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Country | US
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Telephone | 406-396-6565
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Fax |
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Provider Business Mailing Address
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Address Line | 511 EAST PINE STREET
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City | MISSOULA
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State | MT
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Zip | 59802-4635
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Country | US
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Telephone | 406-396-6565
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1339-LCPC
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License Number State | MT
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