Nicole Russell

NPI #1255168795 in Brown Deer, Wisconsin

Provider Information

NPI Number: 1255168795
Entity Type: Individual
Name: Nicole Russell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Enumeration Date: Sep 18, 2024
Last Updated: Sep 18, 2024

Practice Location

Address: 3900 W BROWN DEER RD STE 200
City: Brown Deer
State: Wisconsin
ZIP Code: 53209-1220
Phone: (414) 540-2170

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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