Individual
DOROTHY NICOLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
507 S BROAD ST, MIDDLETOWN, DE 19709-1464
(440) 865-0975
Mailing address
507 S BROAD ST, MIDDLETOWN, DE 19709-1464
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
24640
MD
1041C0700X
Clinical Social Worker
Primary
Q1-0012164
DE
Other
Enumeration date
03/14/2023
Last updated
07/13/2023
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