Provider Demographics
NPI:1588496186
Name:CAMPBELL, KIANA YVONNE (MSED)
Entity type:Individual
Prefix:
First Name:KIANA
Middle Name:YVONNE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 S BROWN PL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6582
Mailing Address - Country:US
Mailing Address - Phone:605-691-5221
Mailing Address - Fax:
Practice Address - Street 1:2210 S BROWN PL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6582
Practice Address - Country:US
Practice Address - Phone:605-691-5221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health