Amy Russell

NPI #1104291459 in Cheyenne, Wyoming

Provider Information

NPI Number: 1104291459
Entity Type: Individual
Name: Amy Russell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Enumeration Date: Dec 10, 2015
Last Updated: Dec 10, 2015

Practice Location

Address: 1911 E 22ND ST
City: Cheyenne
State: Wyoming
ZIP Code: 82001-4142
Phone: (307) 631-6250

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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