Provider Demographics
NPI:1316450547
Name:CAMPBELL, EMILY (QMHS)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:KENNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:224 COLUMBUS RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-1334
Mailing Address - Country:US
Mailing Address - Phone:740-592-6724
Mailing Address - Fax:740-592-6728
Practice Address - Street 1:224 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1334
Practice Address - Country:US
Practice Address - Phone:740-592-6724
Practice Address - Fax:740-592-6728
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst