Individual
DR. RUSSELL FEDERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
918 9 1/2 ST NE, CHARLOTTESVILLE, VA 22902-5311
(434) 962-7495
Mailing address
918 9 1/2 ST NE, CHARLOTTESVILLE, VA 22902-5311
(434) 962-7495
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002911
VA
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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