Individual
JULIET RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5164
Mailing address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5164
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C.1300304-CR
OH
101YM0800X
Mental Health Counselor
Primary
C.1300304-CR
OH
Other
Enumeration date
05/20/2014
Last updated
03/17/2018
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