Provider Demographics
NPI:1053942979
Name:CAMPBELL, MORGAN BREAUX (BCBA)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:BREAUX
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:ALEXIS
Other - Last Name:BREAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3815 EASTSIDE ST APT 3035
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3835
Mailing Address - Country:US
Mailing Address - Phone:047-710-2917
Mailing Address - Fax:
Practice Address - Street 1:2620 TECHNOLOGY FOREST BLVD
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-3904
Practice Address - Country:US
Practice Address - Phone:713-388-6475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2524103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst