Individual
MS. PAMELA JEAN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
6065 HELEN AVE, BERKELEY, MO 63134-2013
(314) 522-6410
Mailing address
6065 HELEN AVE, BERKELEY, MO 63134-2013
(314) 522-6410
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2008001872
MO
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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