Individual
SARAH RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC-CI III
Contact information
Practice address
1445 LAKESIDE ESTATES DR, APT 1612, HOUSTON, TX 77042-2277
(832) 314-8853
Mailing address
1445 LAKESIDE ESTATES DR, #1612, HOUSTON, TX 77042-2277
(832) 314-8853
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14350
TX
Other
Enumeration date
10/19/2016
Last updated
10/25/2016
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