Individual
MR. CLAUDE J RUSSELL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1406 HAWN AVE, SHREVEPORT, LA 71107-6532
(318) 226-5990
Mailing address
1406 HAWN AVE, SHREVEPORT, LA 71107-6532
(318) 226-5990
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
—
Other
Enumeration date
09/19/2016
Last updated
09/19/2016
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