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1386196525
BRANDON JEFFERSON RUSSELL
LOUISBURG, NC
NPI
1386196525
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: NC A12597)
Enumeration Date
2016-11-03
Last Update Date
2019-07-23
Business Address
BRANDON JEFFERSON RUSSELL LPCA, NCC
104 N MAIN ST
LOUISBURG, NC 27549-2516
Phone number: 919-496-7781
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Mailing Address
BRANDON JEFFERSON RUSSELL LPCA, NCC
104 N MAIN ST
LOUISBURG, NC 27549-2516
Phone number: 919-496-7781
Copy
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