| Doctor Name: | MS. JULIE RUSSELL |
| NPI Number: | 1003145152 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHCNS-BC |
| License Number: | 0015000440 |
| Business Practice Address: | 5597 Cedar Break Dr Centreville, VA - 201203329 |
| Business Phone Number: | 7038306315 |
| Business Fax Number: | |
| Mailing Address: | 443 Carlisle Dr Ste A, HERNDON |
| State: | VA |
| Postal Code: | 201705623 |
| Phone Number: | 7035815875 |
| Fax Number: | |
| NPI Enumeration Date: | 12/21/2009 |
| NPI Last Update Date: | 12/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0809X |
| License Number: | 0015000440 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |