Jessica Mykenzie Campbell
Individual provider Active NPI Behavior Technician · Salem, UT
NPI 1396414769 · NPPES record last updated Sep 9, 2021
Key facts
- NPI
- 1396414769
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 345 N State Road 198
Salem, UT 84653-5719 - Phone
- (801) 423-3000
- NPI assigned
- Sep 9, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Who Count | Past |
Accepting new patients | |
| Kids Who Count | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
345 N State Road 198
Salem, UT 84653-5719
Mailing address
345 N State Road 198
Salem, UT 84653-5719
Other providers in Salem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.