Individual
KYLIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
403 WASHINGTON ST, CEDAR FALLS, IA 50613-2840
(319) 289-0191
Mailing address
3229 TERRACE DR, CEDAR FALLS, IA 50613-6067
(515) 494-4245
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
095226
IA
Other
Enumeration date
06/25/2019
Last updated
12/02/2020
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