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General NPI Number Information
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NPI Number | 1679806269
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Entity Type | Individual
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Provider Name | JANE L MCCAMPBELL MA, LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 12/18/2011
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Provider Practice Location Address
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Address Line | 821 RAYMOND AVE SUITE 325
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City | SAINT PAUL
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State | MN
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Zip | 55114-1503
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Country | US
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Telephone | 612-414-0383
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Fax | 952-926-3414
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Provider Business Mailing Address
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Address Line | 821 RAYMOND AVE SUITE 325
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City | SAINT PAUL
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State | MN
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Zip | 55114-1503
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Country | US
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Telephone | 612-414-0383
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Fax | 952-926-3414
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1918
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License Number State | MN
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