RUSSELL JA

SAN JOSE, CA
NPI1215421516
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2018-06-20
Last Update Date2022-01-03
Business Address
Mr. RUSSELL JA
1885 LUNDY AVE STE 223
SAN JOSE, CA 95131-1888
Phone number: 408-284-9079
Mailing Address
Mr. RUSSELL JA
1885 LUNDY AVE STE 223
SAN JOSE, CA 95131-1888
Phone number: 408-284-9079