Emily Jean Campbell, OTRL

Individual provider Active NPI Pediatric Occupational Therapist · Fort Walton Beach, FL

NPI 1962745646 · NPPES record last updated Jul 15, 2019

Key facts

NPI
1962745646
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
License
OT15000 (FL)
Practice address
266 Kidd St
Fort Walton Beach, FL 32548-4478
Phone
(850) 582-2689
Fax
(850) 244-0971
NPI assigned
Apr 1, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OT15000FLMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Occupational Therapist PA Current
since Oct 17, 2021
Accepting new patients
Crena Kersey Pediatric Occupational Therapist PA Current
since Jul 28, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT15000 FL Yes

Addresses

Primary practice location

266 Kidd St
Fort Walton Beach, FL 32548-4478

Mailing address

2 Sherwood Dr
Shalimar, FL 32579-1024
Phone (408) 786-7679

Other providers in Fort Walton Beach, FL

All providers in Fort Walton Beach, FL · Pediatric Occupational Therapist in Florida

Sources for this page

Verify at the official NPI Registry.