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1124865944
JENIFER RUSSELL
SAN DIEGO, CA
NPI
1124865944
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-07-09
Last Update Date
2024-07-09
Business Address
JENIFER RUSSELL SUDCC
4141 PACIFIC HWY
SAN DIEGO, CA 92110-2030
Phone number: 619-849-8665
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Mailing Address
JENIFER RUSSELL SUDCC
4141 PACIFIC HWY
SAN DIEGO, CA 92110-2030
Phone number: 619-849-8665
Copy
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