KENNETH CLYDE RUSSELL

COLUMBUS, OH
NPI1033894324
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  cdca.184930)
Enumeration Date2023-06-15
Last Update Date2023-06-19
Business Address
Mr. KENNETH CLYDE RUSSELL CDCA
1320 PARSONS AVE
COLUMBUS, OH 43206-3642
Phone number: 614-443-2777
Mailing Address
Mr. KENNETH CLYDE RUSSELL CDCA
248 RHOADS AVE
COLUMBUS, OH 43205-2238
Phone number: 614-948-9604