Provider Demographics
NPI:1215421946
Name:CAMP, PATRICIA RUTH LEE (MED)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:RUTH LEE
Last Name:CAMP
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 SHALLOWFORD RD STE O
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1994
Mailing Address - Country:US
Mailing Address - Phone:423-509-4128
Mailing Address - Fax:
Practice Address - Street 1:6110 SHALLOWFORD RD STE O
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1994
Practice Address - Country:US
Practice Address - Phone:423-509-4128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor