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DR. MICHAEL LEE RUSSELL PH.D.

Clinical Neuropsychologist

Fort Monroe, Virginia

Provider NPI: 1255304887

Provider Information:
DR. MICHAEL LEE RUSSELL PH.D.
Gender: M


Practice Location:
HQ, TRADOC, SUITE 412 ATBO-M BLDG 82, 60 INGALLS ROAD FORT MONROE, VA 23651 US
Tel: 757-788-2229  Fax: 757-788-2962

Business Mailing Address:
454 GULICK DR. APARTMENT B FORT MONROE, VA 23651 US
Tel: 757-788-2229  Fax: 757-788-2962

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
WAPY00002256
X103TC0700XBehavioral Health & Social Service Providers
Psychologist
WAPY00002256









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