Individual
MICHAEL FRANK RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COUNSELOR
Contact information
Practice address
2217 E FRANKLIN ST, RICHMOND, VA 23223-7046
(804) 213-0249
(804) 716-0715
Mailing address
2217 E FRANKLIN ST, RICHMOND, VA 23223-7046
(804) 213-0249
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1341
VA
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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