| NPI | 1487203485 |
|---|---|
| Other Name | MATTHEW E.B. RUSSELL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071021089) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 38283) |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2026-04-02 |