| Doctor Name: | MR. RUSSELL VERNON PEARSON |
| NPI Number: | 1225022148 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW |
| License Number: | LCSW-4155 |
| Business Practice Address: | 288 N Ironwood Dr Apache Junction, AZ - 852203830 |
| Business Phone Number: | 4809822356 |
| Business Fax Number: | 4809822449 |
| Mailing Address: | 3717 E Shapinsay Dr, QUEEN CREEK |
| State: | AZ |
| Postal Code: | 852425038 |
| Phone Number: | 4809879460 |
| Fax Number: | |
| NPI Enumeration Date: | 09/07/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCSW-4155 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |