Individual
MR. RUSSELL W TALBOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
561 E TABERNACLE ST, ST GEORGE, UT 84770-2944
(435) 673-2822
Mailing address
561 E TABERNACLE ST, ST GEORGE, UT 84770-2944
(435) 673-2899
(435) 673-0943
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
27813
UT
101YM0800X
Mental Health Counselor
264436-3501
UT
1041C0700X
Clinical Social Worker
Primary
264436-3501
UT
Other
Enumeration date
04/16/2007
Last updated
08/02/2019
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