Individual
MRS. ANDREA RUSSUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1820 MEMORIAL CIR, CLARKSVILLE, TN 37043-4539
(931) 436-2126
Mailing address
417 RIVERMONT DR, CLARKSVILLE, TN 37043-5930
(931) 249-4723
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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