Russell, Robert L
Russell, Robert L is an individual health care provider with primary practice located at 1000 N 92Nd St Child Development Center Of Chw, Milwaukee WI 53226-3533. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Russell, Robert L can be contacted via phone (414) 805-3666.Contact Information
Primary practice address
1000 N 92Nd St Child Development Center Of Chw
Milwaukee WI 53226-3533
Phone: (414) 805-3666
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 2428 | Wisconsin |
Profile Details
| NPI number | 1922050608 |
|---|---|
| LBN Legal business name | Russell, Robert L |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2006 |
| Last updated | Jul 8th, 2007 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922050608 | NPPES |
| Wisconsin | MEDICAID | 39139800 |
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