Individual
CARISSA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, CSW-I, M.ED.
Contact information
Practice address
407 N WALSH ST, CARSON CITY, NV 89701-4268
(775) 298-6386
Mailing address
6 YORKTOWN DR, CARSON CITY, NV 89703-3636
(775) 671-5728
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11251-M
NV
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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