Provider Demographics
NPI:1962878751
Name:MAUREEN CAMPION
Entity type:Organization
Organization Name:MAUREEN CAMPION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-483-3487
Mailing Address - Street 1:6607 18TH AVE S STE 201
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2700
Mailing Address - Country:US
Mailing Address - Phone:612-483-3487
Mailing Address - Fax:
Practice Address - Street 1:6607 18TH AVE S STE 201
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2700
Practice Address - Country:US
Practice Address - Phone:612-483-3487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREGNANCY & POSTPARTUM SUPPORT MN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-15
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 4079103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty