Doctor Name: | MRS. DEBORAH LEE RUSSELL |
NPI Number: | 1447307830 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 587 |
Business Practice Address: | 10110 S 7650 E Crow Agency, MT - 590220009 |
Business Phone Number: | 4066382626 |
Business Fax Number: | 4066383431 |
Mailing Address: | Po Box 192, GARRYOWEN |
State: | MT |
Postal Code: | 590310192 |
Phone Number: | 4066383491 |
Fax Number: | 4066383431 |
NPI Enumeration Date: | 01/05/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 587 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |