Individual
MRS. LESLIE S RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
210 S RIO GRANDE ST, SALT LAKE CITY, UT 84101-1104
(801) 355-9391
(801) 359-8254
Mailing address
210 S RIO GRANDE ST, SALT LAKE CITY, UT 84101-1104
(801) 355-9391
(801) 359-8254
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
133036-3502
UT
Other
Enumeration date
07/01/2008
Last updated
07/01/2008
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