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