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Individual

MR. BRYON RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
260 CHAPMAN RD STE 104A, NEWARK, DE 19702-5410
(302) 468-7238
Mailing address
322 NORWALK WAY, MIDDLETOWN, DE 19709-8371
(302) 547-8431

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00799300
NJ
101YM0800X
Mental Health Counselor
37AC00799300
NJ
101YP2500X
Professional Counselor
37AC00799300
NJ

Other

Enumeration date
06/18/2024
Last updated
06/18/2024
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