Individual
LACHAN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
712 SOUTH AVE, WILKINSBURG, PA 15221-2940
(412) 243-3400
Mailing address
712 SOUTH AVE, WILKINSBURG, PA 15221-2940
(412) 243-3400
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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