Individual
ANDREA SYNNESTVEDT RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4230 COPPER RIDGE DR, TRAVERSE CITY, MI 49684-7256
(231) 935-6380
(231) 935-6920
Mailing address
800 COTTAGEVIEW DR STE 1076, TRAVERSE CITY, MI 49684-2614
(231) 218-6664
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801085121
MI
Other
Enumeration date
09/20/2006
Last updated
01/17/2024
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