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NPI Code Detail

MEDICARE: KALA CAMPBELL

MEDICARE:   KALA  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
11041C0700XClinical Social Worker15145MD

General Provider Information

NPI Number : 1679946354
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALA CAMPBELL
Provider Business Mailing Address
First Line : 200 CABIN BRANCH RD
Second Line :
City : CAPITOL HEIGHTS
State : MD
Zip : 20743-3205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 CABIN BRANCH RD
Second Line :
City : CAPITOL HEIGHTS
State : MD
Zip : 20743-3205
Country : US
Telephone Number : 301-499-7080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2015
Last Update Date : 11/04/2015

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Directions to “ KALA CAMPBELL ” Practice Location

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