| Doctor Name: | RALPH J RUSSELL |
| NPI Number: | 1649394008 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 175 LCSW |
| Business Practice Address: | Rr 1 Box 67 Harlem, MT - 595269705 |
| Business Phone Number: | 4063533100 |
| Business Fax Number: | 4063533229 |
| Mailing Address: | 319 9th Ave, HAVRE |
| State: | MT |
| Postal Code: | 595013754 |
| Phone Number: | 4063533162 |
| Fax Number: | 4063533308 |
| NPI Enumeration Date: | 03/19/2007 |
| NPI Last Update Date: | 02/01/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 175 LCSW |
| 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 |