Individual
AMBER D RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
400 E MAIN ST, PETERSBURG, IN 47567-1245
(812) 354-8785
(812) 354-8786
Mailing address
515 BAYOU ST, VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33005551A
IN
Other
Enumeration date
09/09/2008
Last updated
03/03/2009
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