Individual
MRS. LEANNE K RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5815 BROADWAY AVE, GREAT BEND, KS 67530-3123
(620) 792-2544
(620) 792-7052
Mailing address
5815 BROADWAY AVE, GREAT BEND, KS 67530-3123
(620) 792-2544
(620) 792-7052
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2161
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435201
—
SC
Enumeration date
01/08/2014
Last updated
11/03/2016
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