CLEMENT STREET RUSSELL

LOUISVILLE, KY
NPI1851767974
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: KY  170475)
Enumeration Date2015-08-12
Last Update Date2016-10-04
Business Address
-- CLEMENT STREET RUSSELL Psy.D.
912 LILY CREEK RD #201
LOUISVILLE, KY 40243-2815
Phone number: 502-338-0608
Mailing Address
-- CLEMENT STREET RUSSELL Psy.D.
912 LILY CREEK RD #201
LOUISVILLE, KY 40243-2815
Phone number: 502-338-0608
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