Doctor Name: | DR. RUSSELL EDWARD VANCE |
NPI Number: | 1326352287 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 39000214A |
Business Practice Address: | 8000 Lauderdale Dr Evansville, IN - 477156238 |
Business Phone Number: | 8125500127 |
Business Fax Number: | |
Mailing Address: | 8000 Lauderdale Dr, EVANSVILLE |
State: | IN |
Postal Code: | 477156238 |
Phone Number: | 8125500127 |
Fax Number: | |
NPI Enumeration Date: | 08/03/2010 |
NPI Last Update Date: | 08/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 39000214A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |