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DR. RUSSELL D PELLA PH.D.

Clinical Neuropsychologist

Tulsa, Oklahoma

Provider NPI: 1700177391

Provider Information:
DR. RUSSELL D PELLA PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
5213 S VANDALIA AVE APT. 4G TULSA, OK 74135 US
Tel: 210-309-5124  Fax: --

Business Mailing Address:
5213 S VANDALIA AVE APT. 4G TULSA, OK 74135 US
Tel: 210-309-5124  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
OK1248
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
TX34782

Other Provider Identifiers:

IssuerNumberStateType
284979601TX05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS OK - Page 1



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