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Individual

ANNIE RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4720 PEACHTREE INDUSTRIAL BLVD STE 4202, BERKELEY LAKE, GA 30071-5738
(678) 336-6128
Mailing address
4720 PEACHTREE INDUSTRIAL BLVD STE 4202, BERKELEY LAKE, GA 30071-5738
(678) 336-6128

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
101YP2500X
Professional Counselor
Primary
LPC009369
GA

Other

Enumeration date
12/19/2016
Last updated
07/18/2024
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