Individual
MR. RONNIE JEROME RUSSELL I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M DIV
Contact information
Practice address
717 HART LN, NASHVILLE, TN 37216-2007
(615) 227-7688
(615) 460-4202
Mailing address
230 VENTURE CIR, NASHVILLE, TN 37228-1604
(615) 460-4288
(615) 460-4202
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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