Individual
ANNE MARTIN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
935 REDGATE AVE, NORFOLK, VA 23507-1517
(757) 668-6100
(757) 668-6109
Mailing address
935 REDGATE AVE, NORFOLK, VA 23507-1517
(757) 668-6100
(757) 668-6109
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904008207
VA
Other
Enumeration date
04/29/2013
Last updated
04/29/2013
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