Individual
DESIREA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, MBA, CRC, LPC
Contact information
Practice address
2001 MARTIN LUTHER KING JR DR SW STE 201, ATLANTA, GA 30310-1101
(404) 476-5498
Mailing address
2290 LAKE ROYALE DR, RIVERDALE, GA 30296-1896
(678) 709-8002
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
009974
GA
Other
Enumeration date
01/11/2018
Last updated
02/08/2021
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