Provider Demographics
NPI:1902586019
Name:CAMPOS, NORMA L
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:L
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2179 ENCINO LOOP
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-1902
Mailing Address - Country:US
Mailing Address - Phone:210-784-0972
Mailing Address - Fax:
Practice Address - Street 1:2179 ENCINO LOOP
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-1902
Practice Address - Country:US
Practice Address - Phone:210-784-0972
Practice Address - Fax:210-346-1549
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No103T00000XBehavioral Health & Social Service ProvidersPsychologist