Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KELLY L RUSSO, PH.D.
Active Sole ProprietorDR. KELLY L RUSSO, PH.D. is a Clinical Psychologist healthcare provider located in ORANGEBURG, South Carolina. NPI 1265664734 is currently active in the NPPES registry. Verify at CMS.
Clinical Psychologist · ORANGEBURG, SC
Registration Details
- NPI Number
- 1265664734
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 18, 2009 (17.022837696354 yrs)
- Last Updated
- May 1, 2014
- License
-
PY-8336 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1767 VILLAGE PARK DRORANGEBURG, SC, 291182475Browse SC providers · Browse ZIP 29118
- Phone
- 8037764000
- Fax
- 8035361719
- Primary Specialty
-
Clinical Psychologist
103TC0700X
Other Clinical Psychologist Providers in ORANGEBURG, SC
| Name | Credential | NPI |
|---|---|---|
| DR. VALERIE LOUISE HOLMSTROM | PHD | 1326091323 |
| DR. REUBEN BENJAMIN RIDGEWAY | PHD | 1821237389 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.