Individual
DR. ALINE GASTON RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.MIN., LCPC, LMFT
Contact information
Practice address
1710 CLAWSON ST, #4, ALTON, IL 62002-4792
(618) 462-1448
(314) 878-4524
Mailing address
824 MCKINLEY BLVD, ALTON, IL 62002-3357
(618) 462-1510
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
IL
Other
Enumeration date
03/21/2006
Last updated
07/08/2007
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