Individual
DR. RUSSELL EDWIN SCABBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
317 E WARWICK DR, SUITE B, ALMA, MI 48801-1085
(989) 463-2779
(989) 463-2064
Mailing address
317 E WARWICK DR, SUITE B, ALMA, MI 48801-1085
(989) 463-2779
(989) 463-2064
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301005159
MI
103TC0700X
Clinical Psychologist
6301005159
MI
103TC1900X
Counseling Psychologist
6301005159
MI
103TF0000X
Family Psychologist
6301005159
MI
103TR0400X
Rehabilitation Psychologist
6301005159
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680B945070
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/06/2006
Last updated
05/27/2009
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