Individual
ABIGAIL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 SPINK ST, WOOSTER, OH 44691-3652
(330) 264-8498
Mailing address
104 SPINK ST, WOOSTER, OH 44691-3652
(330) 264-8498
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C1400238
OH
Other
Enumeration date
06/29/2016
Last updated
07/10/2019
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