LAVONNE LENAIR RUSSELL

WINSTON SALEM, NC
NPI1255090353
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NC  26842)
Enumeration Date2021-12-16
Last Update Date2021-12-16
Business Address
-- LAVONNE LENAIR RUSSELL LCASA
408 CROYDON LN
WINSTON SALEM, NC 27107-6810
Phone number: 336-473-8439
Mailing Address
-- LAVONNE LENAIR RUSSELL LCASA
408 CROYDON LN
WINSTON SALEM, NC 27107-6810
Phone number: 336-473-8439
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