Individual
HEIDI MARIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3545 LINCOLN WAY E STE B, MASSILLON, OH 44646-8624
(833) 510-4357
(866) 460-2997
Mailing address
615 ELSINORE PL STE 200, CINCINNATI, OH 45202-1457
(833) 510-4357
(866) 460-2997
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.166110
OH
172V00000X
Community Health Worker
—
—
Other
Enumeration date
08/28/2017
Last updated
02/14/2022
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