Individual
LILLIAN KATHERINE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9 CENTENNIAL DR UNIT 202, PEABODY, MA 01960-7940
(978) 927-9410
Mailing address
9 CENTENNIAL DR UNIT 202, PEABODY, MA 01960-7940
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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