Individual provider · Type 1 NPI

Kimberly Russell

Mental Health Counselor · San Luis Obispo, CA

NPI number 1629552906 Active

Practice location

1255 Kendall Rd
San Luis Obispo, CA 93401-8750

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1629552906

Kimberly Russell's National Provider Identifier is 1629552906, issued on Sep 21, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Luis Obispo, CA. The record was last updated on Sep 21, 2018.