Individual
ADELL J RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
15706 POMERADO RD, POWAY, CA 92064-2067
(619) 847-7473
Mailing address
15706 POMERADO RD, POWAY, CA 92064-2067
(619) 847-7473
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC46933
CA
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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