Individual
MS. MARY JANELLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1105 LYNNWOOD ST, DURANT, OK 74701-2919
(580) 931-3441
(580) 924-6775
Mailing address
4101 N LONE OAK RD, DURANT, OK 74701-7904
(580) 920-2016
(580) 924-6775
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2697
OK
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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