Organization
LORI RUSSELL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI ANN RUSSELL LCSW, CADC III (OWNER/THERAPIST)
(541) 726-4118
Entity
Organization
Contact information
Practice address
380 Q ST, SPRINGFIELD, OR 97477-2120
(541) 726-4118
Mailing address
PO BOX 148, SPRINGFIELD, OR 97477-0171
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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