MEDICARE: CHIQUITA 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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1346033909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIQUITA CAMPBELL

Provider Business Mailing Address
First Line	:	37607 38TH AVE S
Second Line	:
City	:	AUBURN
State	:	WA
Zip	:	98001-8748
Country	:	US
Telephone Number	:	910-388-4754
Fax Number	:

Provider Business Practice Location Address
First Line	:	37607 38TH AVE S
Second Line	:
City	:	AUBURN
State	:	WA
Zip	:	98001-8748
Country	:	US
Telephone Number	:	910-388-4754
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2025
Last Update Date	:	05/27/2025

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Directions to “ CHIQUITA CAMPBELL ” Practice Location

Language	Start Address	Practice Location

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