Individual
MS. JESSICA NICOLE JACK RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
425 NILES CORTLAND RD SE, WARREN, OH 44484-2478
(330) 856-3975
Mailing address
4206 HOPKINS RD, YOUNGSTOWN, OH 44511-3710
(412) 559-4553
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.1901879
OH
Other
Enumeration date
01/17/2007
Last updated
11/04/2019
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