Individual
BRANDEN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3121 W BROAD ST, COLUMBUS, OH 43204-1306
(614) 869-2002
(614) 792-6240
Mailing address
3121 W BROAD ST, COLUMBUS, OH 43204-1306
(614) 534-1100
(614) 792-6240
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.180083
OH
Other
Enumeration date
04/07/2022
Last updated
04/07/2022
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