Individual
MS. CRYSTAL MICHE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1107 CLOISTER PLACE, COLUMBIA, SC 29210
(803) 216-0370
Mailing address
1107 CLOISTER PLACE, COLUMBIA, SC 29210
(803) 216-0370
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4739
SC
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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