Individual
HEATHER ANN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4155 TUDOR CENTRE DR, SUITE #103, ANCHORAGE, AK 99508-5902
(907) 729-8624
Mailing address
4201 TUDOR CENTRE DR, SUITE #320, ANCHORAGE, AK 99508-5904
(907) 729-8624
(907) 729-8607
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
581
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS2781
—
AK
Enumeration date
10/30/2008
Last updated
12/06/2012
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