Russell R Addeo, PhD
Psychologist in Jacksonville, FL. Individual provider (NPI-1).
NPI number1689698144
StatusActive
Last updated in NPPESMar 3, 2015
Details
- NPI
- 1689698144
- Entity type
- Individual (NPI-1)
- Name
- Russell R Addeo
- Credential
- PhD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 27, 2006
- Last updated
- Mar 3, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | PY5570 | FL | Yes |
| 103G00000X | Clinical Neuropsychologist | PY5570 | FL |
Practice location
3901 University Blvd SJacksonville, FL 32216-4312
Phone 904-858-7216 · Fax 904-858-7255
Mailing address
11735 Glacier Bay DrJacksonville, FL 32256-2989
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