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General NPI Number Information
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NPI Number | 1124564471
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Entity Type | Individual
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Provider Name | MELISSA CAMPBELL LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 7300 COTTAGE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19136-4022
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Country | US
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Telephone | 215-400-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 3286 GAUL ST
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City | PHILADELPHIA
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State | PA
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Zip | 19134-4520
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Country | US
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Telephone | 609-668-5606
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000914
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License Number State | PA
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