Individual
KELLEY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1201 N MULDOON RD, ANCHORAGE, AK 99504-6104
(907) 257-4700
Mailing address
1201 N MULDOON RD, ANCHORAGE, AK 99504-6104
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
09/07/2017
Last updated
01/27/2020
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