Individual
MS. DEE A RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCAC, LISW
Contact information
Practice address
3354 ROAD 124, PAYNE, OH 45880-9101
(260) 223-7545
Mailing address
3354 ROAD 124, PAYNE, OH 45880-9101
(260) 223-7545
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001352A
IN
1041C0700X
Clinical Social Worker
Primary
34006134A
IN
1041C0700X
Clinical Social Worker
I1440160
OH
Other
Enumeration date
07/08/2011
Last updated
12/18/2014
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