Individual
MS. GAIL L RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 S WESTLAWN AVE, CHAMPAIGN, IL 61821-4412
(217) 419-8580
Mailing address
1003 S WESTLAWN AVE, CHAMPAIGN, IL 61821-4412
(217) 419-8580
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
09/14/2011
Last updated
09/14/2011
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