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1497851174
JUANITA GWENDOLYN RUSSELL
SANTA ROSA, CA
NPI
1497851174
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 29702)
Enumeration Date
2006-09-16
Last Update Date
2007-07-08
Business Address
JUANITA GWENDOLYN RUSSELL MFT
4527 MONTGOMERY DR #F
SANTA ROSA, CA 95409
Phone number: 707-547-0567
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Mailing Address
JUANITA GWENDOLYN RUSSELL MFT
4527 MONTGOMERY DR #F
SANTA ROSA, CA 95409
Phone number: 707-547-0567
Copy
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