Individual
BARBARA JEAN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4236 59TH ST W, BRADENTON, FL 34209-6664
(941) 400-2122
Mailing address
6561 WATERS EDGE WAY, LAKEWOOD RANCH, FL 34202-2250
(941) 400-2122
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW9226
FL
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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