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Individual
DIANA MARIE RUSSELL
Active
Individual
DIANA MARIE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
H.H.P
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
385759-00
CA
364SH1100X
Holistic Clinical Nurse Specialist
Primary
385759-00
CA
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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