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1245804475
TERRY PAT RUSSELL
CENTRALIA, WA
NPI
1245804475
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2021-05-13
Last Update Date
2022-08-18
Business Address
TERRY PAT RUSSELL
2428 W REYNOLDS AVE
CENTRALIA, WA 98531-4554
Phone number: 360-330-9044
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Mailing Address
TERRY PAT RUSSELL
2428 W REYNOLDS AVE
CENTRALIA, WA 98531-4554
Phone number: 360-330-9044
Copy
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