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1104261346
JACKIE LEE RUSSELL
DILLINGHAM, AK
NPI
1104261346
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: OR M5424)
Enumeration Date
2013-05-01
Last Update Date
2013-05-01
Business Address
JACKIE LEE RUSSELL LSW, MSW, LMSW
6000 KANAKANAK RD
DILLINGHAM, AK 99576-0130
Phone number: 907-842-5201
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Mailing Address
JACKIE LEE RUSSELL LSW, MSW, LMSW
PO BOX 130
DILLINGHAM, AK 99576-0130
Phone number: 907-842-5201
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