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1215467410
RUSSELL LEE KYLE
TAMPA, FL
NPI
1215467410
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-06-20
Last Update Date
2022-07-21
Business Address
RUSSELL LEE KYLE CRSS, CMMF
7207 N NEBRASKA AVE
TAMPA, FL 33604-4916
Phone number: 813-236-1182
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Mailing Address
RUSSELL LEE KYLE CRSS, CMMF
6709 N RIVER BLVD
TAMPA, FL 33604-6027
Phone number: 813-520-2735
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