Individual
ANN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
380 COPPERFIELD BLVD NE, CONCORD, NC 28025-2402
(704) 403-1800
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2630
NC
101YP2500X
Professional Counselor
2630
NC
Other
Enumeration date
03/01/2006
Last updated
04/06/2022
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