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Individual

MRS. ANGELA RENEE MULLINS-RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
711 W MORGAN AVE, PENNINGTON GAP, VA 24277
(276) 546-5289
(276) 546-5289
Mailing address
711 W MORGAN AVE, PENNINGTON GAP, VA 24277
(276) 546-5289
(276) 546-5289

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701002292
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
143331
ANTHEM BLUE CROSS
VA
Enumeration date
08/31/2006
Last updated
07/08/2007
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