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General NPI Number Information
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NPI Number | 1356503361
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Entity Type | Individual
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Provider Name | RACHELLE KRISTEN CAMPBELL LPC
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Gender | Female
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 03/26/2019
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Provider Practice Location Address
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Address Line | 6303 26 MILE RD STE 120
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City | WASHINGTON
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State | MI
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Zip | 48094-3851
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Country | US
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Telephone | 248-978-5625
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Fax |
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Provider Business Mailing Address
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Address Line | 3651 ACADIA DR
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City | LAKE ORION
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State | MI
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Zip | 48360-2723
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Country | US
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Telephone | 248-978-5625
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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 | 6401009560
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License Number State | MI
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