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Individual
MONIQUE RUSSELL
Active
Individual
MONIQUE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MSW
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
649106-1
NY
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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