Individual
MS. JULIE ANN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
655 SOUTH 7TH STREET BLDG 700/700-A, 78 MDG/SG3, ROBINS AFB, GA 31098
(478) 365-7665
Mailing address
655 7TH ST # 78MDG, ROBINS AFB, GA 31098-2227
(478) 327-8487
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12022
MD
1041C0700X
Clinical Social Worker
8316
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008003457
—
CT
Enumeration date
01/21/2012
Last updated
12/16/2024
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