# MR. RUSSELL PHILIP TARDIF

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1396856993
- **Gender:** Man
- **Credential:** M.A., M.F.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | MX23228 | CA | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 09/06/2023