Individual
ANNE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1821 UNIVERSITY AVE W, SAINT PAUL, MN 55104-2801
(612) 454-2447
Mailing address
1821 UNIVERSITY AVE W, SAINT PAUL, MN 55104-2801
(612) 454-2447
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303757
MN
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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