TERRANCE RUSSELL

TARZANA, CA
NPI1467972851
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2017-06-27
Last Update Date2024-12-10
Business Address
TERRANCE RUSSELL DV Facilitator
18700 OXNARD ST
TARZANA, CA 91356-1413
Phone number: 818-991-1051
Mailing Address
TERRANCE RUSSELL DV Facilitator
1530 W AVENUE K8 APT 49
LANCASTER, CA 93534-6308
Phone number: 323-413-4925