ROBERT BERNARD RUSSELL

ST GEORGE, UT
NPI1386230514
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: UT  11577525-6018)
Enumeration Date2020-12-11
Last Update Date2020-12-11
Business Address
ROBERT BERNARD RUSSELL
620 S 400 E
ST GEORGE, UT 84770-3700
Phone number: 435-656-8918
Mailing Address
ROBERT BERNARD RUSSELL
99 W 300 S
ST GEORGE, UT 84770-3519
Phone number: 435-705-0792