Individual
DR. ANITA JEANNE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
3314 E 51ST ST, SUITE 204F, TULSA, OK 74135-3583
(918) 671-7960
(918) 728-8387
Mailing address
4203 E 75TH PL, TULSA, OK 74136-6126
(918) 671-7960
(918) 728-8387
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
632
OK
Other
Enumeration date
08/02/2006
Last updated
10/27/2011
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