Individual
MICHAEL A RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3300 PENNSYLVANIA AVE SE, WASHINGTON, DC 20020-2408
(202) 491-9672
Mailing address
3300 PENNSYLVANIA AVE SE, WASHINGTON, DC 20020-2408
(202) 491-9672
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/06/2023
Last updated
06/28/2023
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