Individual
LEE A ZOHAUNNIE-RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3864 N 27TH AVE, PHOENIX, AZ 85017-4703
(602) 685-6120
Mailing address
3003 N CENTRAL AVE, SUITE 200, PHOENIX, AZ 85012-2902
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LASAC-13135
AZ
Other
Enumeration date
06/27/2013
Last updated
06/27/2013
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