Individual
JONATHAN SCOTT RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
2126 N 1ST ST STE F, JACKSONVILLE, AR 72076-2868
(501) 982-5000
(501) 982-5007
Mailing address
1815 PLEASANT GROVE RD, JONESBORO, AR 72401-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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