Russell, Debra L

Russell, Debra L is an sole proprietor health care provider with primary practice located at 768 Potomac Ave , Buffalo NY 14209-1025. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Russell, Debra L can be contacted via phone (716) 308-0399.

Contact Information

Primary practice address
768 Potomac Ave Buffalo NY 14209-1025
Phone: (716) 308-0399
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X PR0177321 New York
Behavioral Health & Social Service Providers / School 1041S0200X 679685961 New York

Profile Details

NPI number 1346526969
LBN Legal business name Russell, Debra L
Credentials LCSWR
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 27th, 2011
Last updated Oct 27th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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