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Individual
MR. BRYON RUSSELL
Active
Individual
MR. BRYON RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00799300
NJ
101YM0800X
Mental Health Counselor
37AC00799300
NJ
101YP2500X
Professional Counselor
37AC00799300
NJ
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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