Individual
MRS. LAURA RENAY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMHC
Contact information
Practice address
5414 DAYBREAK PKWY, C-4 #123, SOUTH JORDAN, UT 84009
(385) 355-0830
(385) 308-7477
Mailing address
5414 DAYBREAK PKWY, C-4 #123, SOUTH JORDAN, UT 84009
(385) 355-0830
(385) 308-7477
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10322316-6004
UT
Other
Enumeration date
02/11/2020
Last updated
08/14/2023
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