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1487793907
SUSAN M. RUSSELL
BANGOR, ME
NPI
1487793907
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: ME CC 2971)
Enumeration Date
2007-02-05
Last Update Date
2009-06-01
Business Address
SUSAN M. RUSSELL LCPC
319 UNION ST
BANGOR, ME 04401-4607
Phone number: 207-942-2199
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Mailing Address
SUSAN M. RUSSELL LCPC
34 BEECHWOOD AVE
OLD TOWN, ME 04468-9749
Phone number: 207-827-8977
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