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General NPI Number Information
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NPI Number | 1518625722
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Entity Type | Individual
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Provider Name | MS. AMY CAMPBELL
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Gender | Female
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Dates
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Enumeration Date | 12/04/2021
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 1101 GULF BREEZE PKWY BLDG2, STE 4
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City | GULF BREEZE
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State | FL
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Zip | 32561
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Country | US
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Telephone | 850-404-9905
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Fax |
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Provider Business Mailing Address
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Address Line | 4181 DANAMAR DR
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City | PENSACOLA
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State | FL
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Zip | 32504-7713
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Country | US
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Telephone | 850-791-4673
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH23069
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License Number State | FL
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