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Individual
MR. THOMAS RUSSELL II
Active
Individual
MR. THOMAS RUSSELL II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
94020370
CA
101YM0800X
Mental Health Counselor
94020370
CA
103TS0200X
School Psychologist
101067938
CA
106H00000X
Marriage & Family Therapist
Primary
76881
CA
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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