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Individual

DR. BETTY WRIGHT RUSSELL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LCSW, LMFT, PH.D.

Contact information

Practice address
363 WILLIAMSON RD, SUITE 102, MOORESVILLE, NC 28117-5964
(704) 664-7148
(704) 664-3086
Mailing address
363 WILLIAMSON RD, SUITE 102, MOORESVILLE, NC 28117-5964
(704) 664-7148
(704) 664-3086

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C000914
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
74043
BLUECROSS BLUESHIELD OF N
NC
Enumeration date
12/15/2005
Last updated
07/08/2007
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