Individual
DR. RUSSELL RICHARD WOESSNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1601 WALNUT ST, SUITE 901, PHILADELPHIA, PA 19102-2944
(215) 844-8479
Mailing address
640 W PHIL ELLENA ST, PHILADELPHIA, PA 19119-3523
(215) 844-8479
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS006857L
PA
Other
Enumeration date
05/24/2006
Last updated
07/08/2007
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