Russell, Michele C

Russell, Michele C is an individual health care provider with primary practice located at 3313 N Hilliard St , Fresno CA 93726-5854. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Russell, Michele C can be contacted via phone (559) 227-4810.

Contact Information

Primary practice address
3313 N Hilliard St Fresno CA 93726-5854
Phone: (559) 227-4810
Fax: (559) 227-4167
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PSY20822 California

Profile Details

NPI number 1881614519
LBN Legal business name Russell, Michele C
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Jun 26th, 2008 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1881614519 NPPES
California Other OPL208220 MEDICARE PTAN
California Other PSY208220 MEDICARE PTAN
California Other PSY20822 MEDICARE PTAN

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