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General NPI Number Information
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NPI Number | 1598727729
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Entity Type | Individual
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Provider Name | SUSAN O.K. CAMPAGNOLA L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 414 MAIN ST
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City | WARSAW
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State | VA
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Zip | 22572-4291
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Country | US
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Telephone | 804-333-3671
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Fax | 804-333-3657
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Provider Business Mailing Address
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Address Line | 9228 GEORGE WASHINGTON MEMORIAL HWY
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City | GLOUCESTER
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State | VA
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Zip | 23061-4162
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Country | US
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Telephone | 804-693-5068
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Fax | 804-693-7407
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 0904004978
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License Number State | VA
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