VICTOR JONES RUSSELL

WALLACE, NC
NPI1164563417
Former NameSHARITA LAWSON
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NC  0558)
Enumeration Date2007-02-09
Last Update Date2007-07-08
Business Address
-- VICTOR JONES RUSSELL LCAS, CSAC
116 W MAIN ST
WALLACE, NC 28466-2902
Phone number: 910-285-5527
Mailing Address
-- VICTOR JONES RUSSELL LCAS, CSAC
230 SPRING DR
JACKSONVILLE, NC 28540-9161
Phone number: 910-285-5527
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