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Individual

MS. LINDA J. RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2446 W NEW ORLEANS ST, BROKEN ARROW, OK 74011
(918) 286-3278
(918) 806-2647
Mailing address
2446 W NEW ORLEANS ST, BROKEN ARROW, OK 74011
(918) 286-3278
(918) 806-2647

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4276
OK
101YP2500X
Professional Counselor
Primary
4276
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4276
LICENSE #
OK
Enumeration date
03/18/2009
Last updated
04/25/2019
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