Individual
DR. JAMES THADDEUS RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1131 S MORRISON BLVD, VA OUTPATIENT CLINIC, HAMMOND, LA 70403
(985) 340-2195
(985) 340-3834
Mailing address
61 PARC PL, MANDEVILLE, LA 70471-7282
(985) 626-4363
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
600
LA
Other
Enumeration date
09/12/2006
Last updated
07/08/2007
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