Individual
ALICIA MARY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
700 ROCKMEAD DR STE 213, KINGWOOD, TX 77339-5018
(832) 360-8208
Mailing address
4326 BROADLEAF ST, KINGWOOD, TX 77345-1231
(832) 360-8208
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/23/2018
Last updated
12/23/2018
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