Individual
VICTORIA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4606 LEE ST, ALEXANDRIA, LA 71302-3235
(318) 441-1105
Mailing address
4606 LEE ST, ALEXANDRIA, LA 71302-3235
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/22/2016
Last updated
07/24/2019
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