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General NPI Number Information
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NPI Number | 1154567824
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Entity Type | Organization
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Legal Business Name | ELIZABETH MCCAMPBELL PHD PC
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Dates
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Enumeration Date | 12/30/2008
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 3325 PADDOCKS PKWY STE 415
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City | SUWANEE
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State | GA
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Zip | 30024-6059
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Country | US
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Telephone | 404-216-0252
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Fax |
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Provider Business Mailing Address
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Address Line | 5285 MARSTON RD
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City | ATLANTA
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State | GA
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Zip | 30360-1226
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Country | US
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Telephone | 404-216-0252
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Fax | 678-513-1188
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MICHEAUX HALL
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Credential |
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Telephone | 678-513-0313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 894
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License Number State | GA
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