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Individual

KATHRYN RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4714 MOUNT ALIFAN DR, SAN DIEGO, CA 92111-2508
(858) 229-9315
Mailing address
4714 MOUNT ALIFAN DR, SAN DIEGO, CA 92111-2508

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary

Other

Enumeration date
05/04/2020
Last updated
05/04/2020
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