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General NPI Number Information
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NPI Number | 1992128532
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Entity Type | Organization
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Legal Business Name | JAMES B CAMPBELL LLC
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Dates
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Enumeration Date | 02/03/2014
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Last Update Date | 02/03/2014
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Provider Practice Location Address
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Address Line | 7501 NW 4TH ST SUITE 215
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City | PLANTATION
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State | FL
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Zip | 33317-2245
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Country | US
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Telephone | 954-707-9391
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Fax | 954-587-0982
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Provider Business Mailing Address
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Address Line | 7501 NW 4TH ST SUITE 215
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City | PLANTATION
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State | FL
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Zip | 33317-2245
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Country | US
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Telephone | 954-707-9391
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Fax | 954-587-0982
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES BURTON CAMPBELL
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Credential | PSY.D.
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Telephone | 954-707-9391
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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 | PY 8968
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License Number State | FL
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