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1447889654
PANOLA RUSSELL
COLUMBUS, OH
NPI
1447889654
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH 173218)
Enumeration Date
2020-04-08
Last Update Date
2020-04-08
Business Address
PANOLA RUSSELL
5460 CLEVELAND AVE
COLUMBUS, OH 43231-4005
Phone number: 614-754-8555
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Mailing Address
PANOLA RUSSELL
5460 CLEVELAND AVE
COLUMBUS, OH 43231-4005
Phone number: 614-614-5688
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