Individual
MARIA ANN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
32 HICKORY STREET, BADIN, NC 28009
(704) 322-1143
(704) 422-5041
Mailing address
PO BOX 671, KANNAPOLIS, NC 28082-0671
(828) 387-5735
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7071
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103947
—
NC
Enumeration date
07/17/2008
Last updated
06/11/2013
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