Individual
VICTORIA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
7515 GREENVILLE AVE STE 1000, DALLAS, TX 75231-3852
(714) 809-7450
Mailing address
7515 GREENVILLE AVE STE 1000, DALLAS, TX 75231-3852
(714) 809-7450
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11014
TX
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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