Benjaminrussack
NPI #1083014773 in Mill Valley, California
Provider Information
- NPI Number
- 1083014773
- Entity Type
- Organization
- Organization Name
- Benjaminrussack
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Aug 29, 2014
- Last Updated
- Aug 29, 2014
Practice Location
- Address
- 20 SHELLEY DR APT 6
- City
- Mill Valley
- State
- California
- ZIP Code
- 94941-1562
- Phone
- (415) 497-1908
Authorized Official
- Name
- MR. BENJAMIN D RUSSACK
- Title
- MFT
- Phone
- (415) 497-1908
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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