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NPI Profile for THERESA J RUSSELL in POLLOCK PINES, CA.
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Specialist |
174400000X |
| NPI Number | 1255465530 |
|
| Status | Active | |
| Credentials | CADC-11 | |
| Entity | Individual | |
| Enumeration date | 03/16/2007 | |
| Last updated | 07/08/2007 - About 19 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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THERESA J RUSSELL
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THERESA J RUSSELL, CADC-11