Individual
OLIVIA B RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4735 STATESMEN DR STE A, INDIANAPOLIS, IN 46250-5647
(317) 986-4956
(317) 452-8821
Mailing address
4735 STATESMEN DR STE A, INDIANAPOLIS, IN 46250-5647
(317) 986-4956
(317) 452-8821
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008255A
IN
Other
Enumeration date
10/03/2018
Last updated
03/29/2024
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