Russell, Deirdre Kay
Russell, Deirdre Kay is an sole proprietor health care provider with primary practice located at 8211 Village Harbor Dr , Cornelius NC 28031-3706. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Russell, Deirdre Kay can be contacted via phone (704) 455-2014.Contact Information
Primary practice address
8211 Village Harbor Dr
Cornelius NC 28031-3706
Phone: (704) 455-2014
Fax: (704) 896-7836
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 2418 | North Carolina |
Profile Details
| NPI number | 1821203126 |
|---|---|
| LBN Legal business name | Russell, Deirdre Kay |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 11th, 2007 |
| Last updated | Feb 17th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821203126 | NPPES |
| North Carolina | MEDICAID | 6000485 | |
| North Carolina | Other | 292157000 |
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