Individual
KENDA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8001 S. HWY 75, SHERMAN, TX 75090
(903) 532-1400
(903) 532-1401
Mailing address
PO BOX 338, HOWE, TX 75459-5707
(903) 532-1400
(903) 532-1401
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
14636
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14636
LMSW
TX
Enumeration date
07/29/2009
Last updated
08/20/2009
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