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Individual

ROBERT RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ED.S.

Contact information

Practice address
1009 WOODLAWN PARK DR, FLINT, MI 48503-2762
(810) 252-0443
Mailing address
1009 WOODLAWN PARK DR, FLINT, MI 48503-2762
(810) 252-0443

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
CC-1C4740407757
MI

Other

Enumeration date
12/21/2013
Last updated
12/21/2013
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