Individual
JILLIAN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
16 HAWTHORNE CT, HIGGANUM, CT 06441-4281
(860) 335-6145
Mailing address
16 HAWTHORNE CT, HIGGANUM, CT 06441-4281
(860) 335-6145
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12308
CT
Other
Enumeration date
01/13/2020
Last updated
05/14/2024
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