Most Relevant Information
Provider Data
| NPI Number: | 1003399601 |
| Provider Name: | JUANITA M CAMPBELL LBSC |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | BH001975 |
Most Important Dates
| Enumeration Date: | 09/10/2018 |
| Last Updated: | 09/10/2018 |
Provider Practice Location
2911 S 67TH ST
PHILADELPHIA
PA
191422604
Practice Location Phone/Fax
| Phone: | 2153509998 |
| Fax: |
Provider Mailing Location
2625 S 80TH ST
PHILADELPHIA
PA
191531734
Provider Mailing Phone/Fax
| Phone: | 2153509998 |
| Fax: |