Provider Demographics
NPI:1417021478
Name:CAMPBELL, MARGARET F (PHD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:F
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 HANOVER ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WB
Mailing Address - State:PA
Mailing Address - Zip Code:18702
Mailing Address - Country:US
Mailing Address - Phone:570-822-5191
Mailing Address - Fax:570-822-2450
Practice Address - Street 1:166 HANOVER ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WB
Practice Address - State:PA
Practice Address - Zip Code:18702
Practice Address - Country:US
Practice Address - Phone:570-822-5191
Practice Address - Fax:570-822-2450
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008724L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA571130Medicare UPIN
PA028476Medicare ID - Type Unspecified