Individual
DR. RUSSELL ANDREW MCCANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
444 W FORT ST FL 2, BOISE, ID 83702-4535
(208) 422-1018
Mailing address
444 W FORT ST FL 2, BOISE, ID 83702-4535
(208) 422-1018
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY60317242
WA
Other
Enumeration date
11/17/2008
Last updated
08/30/2023
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