Individual
CHRISTINE BLAIR RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
321 HAMILTON ST, GENEVA, IL 60134-2148
(630) 686-2282
Mailing address
804 STATE ST, ST CHARLES, IL 60174-1753
(682) 560-5652
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.021431
IL
Other
Enumeration date
09/05/2019
Last updated
10/14/2020
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