Individual
AMBER RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
85 OLD OCEAN HOUSE RD, CAPE ELIZABETH, ME 04107-2632
(207) 482-9360
Mailing address
85 OLD OCEAN HOUSE RD, CAPE ELIZABETH, ME 04107-2632
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC13010
ME
1041C0700X
Clinical Social Worker
MC11835
ME
Other
Enumeration date
10/07/2009
Last updated
03/11/2014
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