Individual provider · Type 1 NPI

Kelly Amanda Taylor Russell, M.A.

Mental Health Counselor · Boulder, CO

NPI number 1376975946 Active

Practice location

1333 Iris Ave
Boulder, CO 80304-2226

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1376975946

Kelly Amanda Taylor Russell, M.A.'s National Provider Identifier is 1376975946, issued on Aug 5, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Boulder, CO. The record was last updated on Aug 5, 2013.