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1467190777
THOMAS MICHAEL RUSSELL
BOWLING GREEN, KY
NPI
1467190777
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Former Name
THOMAS MICHAEL RUSSELL
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2022-05-25
Last Update Date
2022-05-25
Business Address
Mr. THOMAS MICHAEL RUSSELL BA
5966 SCOTTSVILLE RD
BOWLING GREEN, KY 42104-0387
Phone number: 270-904-5104
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Mailing Address
Mr. THOMAS MICHAEL RUSSELL BA
211 WESTBROOK RD
ALVATON, KY 42122-8682
Phone number: 502-553-5746
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