Individual
DR. TIFFANY D RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
293 CENTENNIAL DR, GRAND FORKS, ND 58202-6066
(701) 777-3745
Mailing address
293 CENTENNIAL DR, GRAND FORKS, ND 58202-6066
(701) 777-3745
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
661
ND
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/08/2015
Last updated
06/19/2026
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