| NPI | 1780860817 |
|---|---|
| Former Name | KATHRYN PHILOMENA RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 091566) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCSW82429) |
| 1041C0700X Social Worker, Clinical (Licence: ME LC14617) | |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2023-01-02 |