Individual
LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, ACSW, QP, CS
Contact information
Practice address
14954 N COEUR DALENE ST, RATHDRUM, ID 83858-6484
(208) 687-0538
(208) 687-3185
Mailing address
14954 N COEUR DALENE ST, RATHDRUM, ID 83858-6484
(208) 687-0538
(208) 687-3185
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW 35159
ID
Other
Enumeration date
08/26/2014
Last updated
02/18/2016
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