Individual
WENDY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
343 S MAIN ST, BEAVER DAM, KY 42320
(270) 228-2414
Mailing address
PO BOX 292, BEAVER DAM, KY 42320-0292
(270) 228-2414
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
163595
KY
Other
Enumeration date
08/13/2014
Last updated
07/30/2018
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