Individual
DR. RUSSELL DEWARD CROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
29406
MS
103T00000X
Psychologist
Primary
P773
TN
Other
Enumeration date
03/27/2006
Last updated
07/08/2007
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