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Individual

KAHALA RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, CCAADC

Contact information

Practice address
6815 FOREST PARK DR STE 122, SAVANNAH, GA 31406-1511
(912) 335-7915
(888) 417-8783
Mailing address
6815 FOREST PARK DR STE 122, SAVANNAH, GA 31406-1511
(912) 335-7915
(888) 417-8783

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C0117
GA
101YP2500X
Professional Counselor
Primary
LPC007127
GA

Other

Enumeration date
06/14/2013
Last updated
06/14/2013
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