Individual
MS. KRISTINA T RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1525 SANDER CT APT 316, WHEELING, IL 60090-5960
(773) 844-3869
Mailing address
1525 SANDER CT APT 316, WHEELING, IL 60090-5960
(773) 844-3869
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
1041S0200X
School Social Worker
Primary
2360552
IL
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
06/29/2011
Last updated
12/16/2019
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