Provider Demographics
NPI:1225929078
Name:CAMPBELL, RYAN LEE
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:LEE
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9752 N RUSCHIA AVE
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85653-0030
Mailing Address - Country:US
Mailing Address - Phone:480-201-2442
Mailing Address - Fax:
Practice Address - Street 1:7440 N ORACLE RD BLDG 7
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-6385
Practice Address - Country:US
Practice Address - Phone:520-815-7991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-16384106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist