Provider Demographics
NPI:1083702310
Name:RUSSELL-CURRY, PATRICIA ANN (MFT ADTR)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:RUSSELL-CURRY
Suffix:
Gender:F
Credentials:MFT ADTR
Other - Prefix:
Other - First Name:PATTEE
Other - Middle Name:
Other - Last Name:RUSSELL-CURRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT ADTR
Mailing Address - Street 1:2805 G ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340
Mailing Address - Country:US
Mailing Address - Phone:209-722-7030
Mailing Address - Fax:209-722-7029
Practice Address - Street 1:2805 G ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340
Practice Address - Country:US
Practice Address - Phone:209-722-7030
Practice Address - Fax:209-722-7029
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC27481106H00000X, 225600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist