Provider Demographics
NPI:1871730242
Name:CAMPBELL, TODD COLE (PHD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:COLE
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 N 15TH ST
Mailing Address - Street 2:RM 150 SCHROEDER COMPLEX MARQUETTE UNIVERSITY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-2237
Mailing Address - Country:US
Mailing Address - Phone:414-288-5889
Mailing Address - Fax:414-288-6100
Practice Address - Street 1:561 N 15TH ST
Practice Address - Street 2:RM 150 SCHROEDER COMPLEX MARQUETTE UNIVERSITY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-2237
Practice Address - Country:US
Practice Address - Phone:414-288-5889
Practice Address - Fax:414-288-6100
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2158103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist