Individual
CAMERON RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
40 ORRS LN, TRIADELPHIA, WV 26059-1455
(304) 809-9865
Mailing address
96 WESTGATE DR, WHEELING, WV 26003-4985
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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