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1245380781
DIANE GAIL RUSSELL
ROSEVILLE, MI
NPI
1245380781
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6801066657)
Enumeration Date
2007-01-10
Last Update Date
2007-07-08
Business Address
Ms. DIANE GAIL RUSSELL M.S.W.
25869 KELLY RD SUITE A
ROSEVILLE, MI 48066-4997
Phone number: 586-773-6020
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Mailing Address
Ms. DIANE GAIL RUSSELL M.S.W.
25869 KELLY RD SUITE A
ROSEVILLE, MI 48066-4997
Phone number: 586-773-6020
Copy
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