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NPI Code Detail

MEDICARE: LAURA CAMPBELL

MEDICARE: LAURA CAMPBELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1124743653
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA CAMPBELL
Provider Business Mailing Address
First Line : 1725 E KANE PL APT 107
Second Line :
City : MILWAUKEE
State : WI
Zip : 53202-1748
Country : US
Telephone Number : 651-494-4019
Fax Number :
Provider Business Practice Location Address
First Line : 6140 W EXECUTIVE DR
Second Line :
City : MEQUON
State : WI
Zip : 53092-4499
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2022
Last Update Date : 10/06/2022

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Directions to “ LAURA CAMPBELL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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