Individual
ELIZABETH R RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, BS
Contact information
Practice address
9609 JEFFERSON DAVIS HWY, NORTH CHESTERFIELD, VA 23237-4621
(804) 275-1116
(804) 275-1850
Mailing address
9609 JEFFERSON DAVIS HWY, NORTH CHESTERFIELD, VA 23237-4621
(804) 275-1116
(804) 275-1850
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/07/2017
Last updated
12/07/2017
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