Individual
MISS ANDREA MARIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
23140 MOAKLEY ST STE 623140, LEONARDTOWN, MD 20650-2930
(301) 690-8404
Mailing address
23247 WHITE BIRCH CT APT 127, CALIFORNIA, MD 20619-6056
(785) 207-5529
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
15720
MD
1041C0700X
Clinical Social Worker
Primary
7100
KS
Other
Enumeration date
07/08/2008
Last updated
10/09/2023
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