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1467832824
SAMANTHA JO RUSSELL
CERES, CA
NPI
1467832824
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Former Name
SAMANTHA JO PLATEAU
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 107583)
Enumeration Date
2015-06-01
Last Update Date
2024-08-28
Business Address
SAMANTHA JO RUSSELL MFT
1904 RICHLAND AVE BLDG A
CERES, CA 95307-4562
Phone number: 209-543-0440
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Mailing Address
SAMANTHA JO RUSSELL MFT
1904 RICHLAND AVE BLDG A
CERES, CA 95307-4562
Phone number:
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