Individual
ANGELA L RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1400 MERCANTILE LN, 232, LARGO, MD 20774-5341
(301) 583-0001
(301) 583-3403
Mailing address
1400 MERCANTILE LN, 232, LARGO, MD 20774-5341
(301) 583-0001
(301) 583-3403
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC1591
MD
Other
Enumeration date
06/05/2006
Last updated
07/20/2007
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