Individual
MS. ADRIAN ANITA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LASAC
Contact information
Practice address
2400 N CENTRAL AVE STE 101, PHOENIX, AZ 85004-1300
(602) 264-9891
(602) 234-2639
Mailing address
6615 NORTH 17TH AVE APT B2, 6615 NORTH 17TH AVE APT B2, PHOENIX, AZ 85015
(480) 751-0488
(602) 234-2639
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13352
AZ
Other
Enumeration date
06/22/2017
Last updated
06/16/2018
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