Individual
MR. KENNETH LADON RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11000 SPRINGHOLLOW RD, OKLAHOMA CITY, OK 73120-5021
(405) 245-1303
Mailing address
11000 SPRINGHOLLOW RD, OKLAHOMA CITY, OK 73120-5021
(405) 245-1303
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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