| NPI | 1881560050 |
|---|---|
| Former Name | DAVIDA RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SD 6919) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 35364) |
| Enumeration Date | 2025-10-15 |
| Last Update Date | 2025-10-24 |