Individual
LITA WILSON RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
141 PROVIDENCE RD, STE 100, CHAPEL HILL, NC 27514-6219
(919) 601-7985
(888) 208-9941
Mailing address
141 PROVIDENCE RD, STE 100, CHAPEL HILL, NC 27514-6219
(919) 601-7985
(888) 208-9941
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2532
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0441W
BCBS
NC
Enumeration date
01/31/2007
Last updated
04/10/2020
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