Individual
BRAYDEN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
6952 DOGWOOD MNR N STE 104, OLIVE BRANCH, MS 38654-2091
(901) 571-8911
Mailing address
6952 DOGWOOD MNR N STE 104, OLIVE BRANCH, MS 38654-2091
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M10492
MS
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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