Individual
CHRISTINA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
106 E CENTER ST, CARROLLTON, GA 30117-3303
(678) 777-8509
Mailing address
106 E CENTER ST, CARROLLTON, GA 30117-3303
(678) 777-8509
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004593
GA
Other
Enumeration date
06/18/2009
Last updated
02/04/2012
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