Individual
DR. RUSSELL JAMES BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1675 N FREEDOM BLVD, SUITE 2B2, PROVO, UT 84604-2540
(801) 360-7598
Mailing address
1675 N FREEDOM BLVD, SUITE 2B2, PROVO, UT 84604-2540
(801) 360-7598
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7809881-2504
UT
Other
Enumeration date
11/24/2010
Last updated
11/24/2010
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