Individual
MISS CATHERINE ANN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
60 E AMHERST ST, BUFFALO, NY 14214-1804
(716) 834-6401
Mailing address
3020 BAILEY AVE, BUFFALO, NY 14215-2814
(716) 662-2889
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C.0600633.TEMP
OH
Other
Enumeration date
07/23/2007
Last updated
07/23/2007
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