Individual
DR. GILLIAN ISAACS RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., NCPSYA
Contact information
Practice address
100 ARAPAHOE AVE, SUITE 12, BOULDER, CO 80302-5854
(605) 431-5022
Mailing address
100 ARAPAHOE AVE, SUITE 12, BOULDER, CO 80302-5854
(605) 431-5022
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
NLC.0105131
CO
Other
Enumeration date
03/18/2015
Last updated
03/18/2015
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