Individual
AMELIA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 W THOUSAND OAKS BLVD, SUITE 500, THOUSAND OAKS, CA 91360-4402
(805) 777-3595
(805) 777-3521
Mailing address
125 W THOUSAND OAKS BLVD, SUITE 500, THOUSAND OAKS, CA 91360-4402
(805) 777-3595
(805) 777-3521
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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