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1386244648
MATTHEW B RUSSELL
FAIR OAKS, CA
NPI
1386244648
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA AMFT122031)
Enumeration Date
2020-10-27
Last Update Date
2020-10-27
Business Address
MATTHEW B RUSSELL
4125 TEMESCAL ST STE G
FAIR OAKS, CA 95628-7558
Phone number: 916-619-7744
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Mailing Address
MATTHEW B RUSSELL
4125 TEMESCAL ST STE G
FAIR OAKS, CA 95628-7558
Phone number: 916-619-7744
Copy
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