Individual
JENNIFER E RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
1 PRESTERA WAY, HUNTINGTON, WV 25705-2069
(304) 525-7851
(304) 525-1073
Mailing address
5600 US ROUTE 60, HUNTINGTON, WV 25705-2146
(304) 525-7851
(304) 525-1073
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1196
WV
Other
Enumeration date
06/14/2018
Last updated
07/08/2024
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