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Individual

MEGHAN RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., C.A.S.

Contact information

Practice address
51 SAINT JOHNS PARKSIDE ST, BUFFALO, NY 14210-2515
(716) 828-9560
(716) 828-9460
Mailing address
11079 MATTESON CORNERS RD, HOLLAND, NY 14080-9311
(716) 807-1300

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary

Other

Enumeration date
06/22/2012
Last updated
06/22/2012
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