NPI | 1295353951 |
---|---|
Former Legal Business Name | DR. PAM RUSSELL, LLC. |
Former Legal Business Name | DR PAM RUSSELL LLC |
Entity Type | Organization |
Authorized Contact | PAMELA RUSSELL RUSSELL CEO 904-830-0737 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP1600X Counselor, Pastoral |
Enumeration Date | 2020-07-09 |
Last Update Date | 2024-08-13 |