Individual
LANETTE KAYE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1175 S ASPEN AVE STE C, BROKEN ARROW, OK 74012-4800
(580) 541-6377
(580) 234-8891
Mailing address
6845 S 224TH EAST AVE, BROKEN ARROW, OK 74014-6606
(580) 541-6377
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
6015
OK
Other
Enumeration date
12/14/2010
Last updated
08/21/2023
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