Individual
ROXIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMHC
Contact information
Practice address
4460 S HIGHLAND DR, SALT LAKE CITY, UT 84124-3543
(888) 949-4864
Mailing address
430 CLOVERDALE RD, NORTH SALT LAKE, UT 84054-2323
(205) 937-6916
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
12440197-6004
UT
Other
Enumeration date
08/23/2021
Last updated
09/18/2024
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