SANDRA CAMPBELL PHD

Clinical Neuropsychologist

Brattleboro, Vermont

Provider NPI: 1427039866

Provider Information:
 SANDRA  CAMPBELL PHD
Gender: F
Not Sole Proprietor

Practice Location:
ANNA MARSH LANE  BRATTLEBORO, VT 05302 US
Tel: 802-257-7785  Fax: --

Business Mailing Address:
ANNA MARSH LANE  BRATTLEBORO, VT 05302 US
Tel: 802-257-7785  Fax: --

Entity Type: Individual

Taxonomy:

Primary	Code	Category/Description	State	License Number
N	103G00000X	Behavioral Health & Social Service Providers Clinical Neuropsychologist	VT	048-0000411
Y	103TC0700X	Behavioral Health & Social Service Providers Psychologist	VT	048-0000411

Other Provider Identifiers:

Issuer	Number	State	Type
	1003256	VT	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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