Individual
MRS. DYANNA LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S, CADC
Contact information
Practice address
250 MILLIONAIRE RD, SAINT PAULS, NC 28384-8251
(910) 241-3273
(319) 390-4381
Mailing address
250 MILLIONAIRE RD, SAINT PAULS, NC 28384-8251
(910) 241-3273
(319) 390-4381
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
IA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/23/2020
Last updated
11/04/2021
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