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Individual

BETTY GRACE RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
901 N JONES BLVD UNIT 213, LAS VEGAS, NV 89108-1603
(702) 626-3230
Mailing address
901 N JONES BLVD UNIT 213, LAS VEGAS, NV 89108-1603
(702) 626-3230

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7437-C
NV
101YM0800X
Mental Health Counselor
C-12165
NM
104100000X
Social Worker
Primary
6120-S
NV

Other

Enumeration date
06/03/2014
Last updated
01/06/2023
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