| Doctor Name: | JAMES RUSSELL |
| NPI Number: | 1063660926 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1090 S Vulture Mine Rd Wickenburg, AZ - 853903145 |
| Business Phone Number: | 9286846600 |
| Business Fax Number: | 9286846628 |
| Mailing Address: | 40 W Yavapai St, WICKENBURG |
| State: | AZ |
| Postal Code: | 853903201 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/04/2008 |
| NPI Last Update Date: | 09/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |