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Individual

DEMETRIA RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
3957 JOST FARM WAY, FLORISSANT, MO 63034-2250
(314) 226-8668
Mailing address
3957 JOST FARM WAY, FLORISSANT, MO 63034-2250
(314) 226-8668

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2024009989
MO
101YP2500X
Professional Counselor
101YS0200X
School Counselor

Other

Enumeration date
03/09/2026
Last updated
03/09/2026
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