Organization
ANNA M RUSSELL LCSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA M RUSSELL (OWNER)
(307) 634-6594
Entity
Organization
Contact information
Practice address
2909 BENT AVE, CHEYENNE, WY 82001-2742
(307) 634-6594
Mailing address
2909 BENT AVE, CHEYENNE, WY 82001-2742
(307) 634-6495
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
231
WY
Other
Enumeration date
10/19/2007
Last updated
11/13/2007
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