Individual
DANNA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
670 12TH ST, OGDEN, UT 84404-5877
(801) 391-3120
Mailing address
670 12TH ST, OGDEN, UT 84404-5877
(801) 391-3120
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6623405-3501
UT
Other
Enumeration date
09/05/2013
Last updated
09/05/2013
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