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1497088157
MICHAEL JOSEPH RUSSELL
FRESNO, CA
NPI
1497088157
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2009-09-14
Last Update Date
2009-09-14
Business Address
Mr. MICHAEL JOSEPH RUSSELL
4928 E CLINTON WAY SUITE 101
FRESNO, CA 93727-1526
Phone number: 559-255-8838
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Mailing Address
Mr. MICHAEL JOSEPH RUSSELL
5679 N HAZEL AVE
FRESNO, CA 93711-2137
Phone number:
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