MEDICARE: JEANNIE MARIE CAMPBELL CCC-SLP

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	235Z00000X	Speech-Language Pathologist	123299	TX

General Provider Information

NPI Number	:	1619410271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNIE MARIE CAMPBELL CCC-SLP

Provider Business Mailing Address
First Line	:	8101 BOAT CLUB RD STE 240-319
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-3630
Country	:	US
Telephone Number	:	682-498-3928
Fax Number	:	214-935-2457

Provider Business Practice Location Address
First Line	:	1140 W PIONEER PKWY STE A
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-6383
Country	:	US
Telephone Number	:	469-587-9397
Fax Number	:	214-935-2457

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

Provider Enumeration Date	:	11/29/2016
Last Update Date	:	04/21/2026

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Directions to “ JEANNIE MARIE CAMPBELL CCC-SLP” Practice Location

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