JUANITA GWENDOLYN RUSSELL

SANTA ROSA, CA
NPI1497851174
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy106H00000X Marriage & Family Therapist
(Licence: CA  29702)
Enumeration Date2006-09-16
Last Update Date2007-07-08
Business Address
JUANITA GWENDOLYN RUSSELL MFT
4527 MONTGOMERY DR #F
SANTA ROSA, CA 95409
Phone number: 707-547-0567
Mailing Address
JUANITA GWENDOLYN RUSSELL MFT
4527 MONTGOMERY DR #F
SANTA ROSA, CA 95409
Phone number: 707-547-0567