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General NPI Number Information
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NPI Number | 1326454182
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Entity Type | Organization
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Legal Business Name | JUNIPER CAMPBELL, PLLC
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 723 COVE PKWY
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4685
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Country | US
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Telephone | 928-254-0113
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3201
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City | SEDONA
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State | AZ
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Zip | 86340-3201
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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 | OWNER
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Name | JUNIPER CAMPBELL
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Credential | LPC
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Telephone | 928-254-0113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LPC-15211
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License Number State | AZ
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