Individual
MRS. ANGELA S. RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
7019 BACKLICK CT, SPRINGFIELD, VA 22151-3903
(703) 971-7898
Mailing address
7024 DARBY TOWNE CT, ALEXANDRIA, VA 22315-4751
(801) 558-6603
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904008240
VA
Other
Enumeration date
05/12/2008
Last updated
10/18/2013
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