Individual
ANNA M RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2909 BENT AVE, CHEYENNE, WY 82001
(307) 634-6594
(307) 638-2959
Mailing address
2909 BENT AVE, CHEYENNE, WY 82001
(307) 634-6594
(307) 638-2959
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
231
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310816
BCBS
WY
01
—
409771
VALUE OPTIONS
WY
Enumeration date
03/02/2007
Last updated
07/08/2007
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