Individual
SUSAN ELIZABETH RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.L.P.C.
Contact information
Practice address
201 MAPLE ST, EAST JORDAN, MI 49727-9620
(231) 459-5606
Mailing address
201 MAPLE ST, EAST JORDAN, MI 49727-9620
(231) 459-5606
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401013753
MI
Other
Enumeration date
12/15/2013
Last updated
03/21/2024
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