Individual
LABREA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAPC
Contact information
Practice address
770 VILLAGE SQUARE DR, STONE MOUNTAIN, GA 30083-3380
(404) 418-2190
Mailing address
PO BOX 4, AVONDALE ESTATES, GA 30002-0004
(404) 418-2190
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APC0075551
GA
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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