Individual
RALPH J RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
RR 1 BOX 67, HARLEM, MT 59526-9705
(406) 353-3100
(406) 353-3229
Mailing address
319 9TH AVE, HAVRE, MT 59501-3754
(406) 353-3162
(406) 353-3308
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
175 LCSW
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175 LCSW
LICENSE
MT
Enumeration date
03/19/2007
Last updated
02/01/2008
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