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General NPI Number Information
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NPI Number | 1659514933
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Entity Type | Organization
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Legal Business Name | LIZ CAMPBELL PHD PL
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Dates
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Enumeration Date | 04/15/2009
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 700 KAYWOOD DR
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City | ORLANDO
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State | FL
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Zip | 32825-8063
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Country | US
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Telephone | 407-282-4644
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 28410
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City | MACON
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State | GA
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Zip | 31221-8410
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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 | PHD
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Name | LIZ CAMPBELL
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Credential |
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Telephone | 478-475-1299
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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 | PY6141
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License Number State | FL
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