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Individual
MR. RUSSELL W TALBOT
Active
Individual
MR. RUSSELL W TALBOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
27813
UT
101YM0800X
Mental Health Counselor
264436-3501
UT
1041C0700X
Clinical Social Worker
Primary
264436-3501
UT
Other
Enumeration date
04/16/2007
Last updated
08/02/2019
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