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Individual

PAULA J. RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
210 MITCHELL ST, PICAYUNE, MS 39466-4540
(601) 799-5886
Mailing address
210 MITCHELL ST, PICAYUNE, MS 39466-4540
(601) 799-5886

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C6315
MS

Other

Enumeration date
08/03/2006
Last updated
07/08/2007
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