MARY RUSSELL

JACKSON, TN
NPI1508321423
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: TN  LDC0000000502)
Enumeration Date2019-02-05
Last Update Date2019-02-05
Business Address
MARY RUSSELL MSW, LADACII
110 MCCOWAT ST
JACKSON, TN 38301-5279
Phone number: 731-427-7238
Mailing Address
MARY RUSSELL MSW, LADACII
110 MCCOWAT ST
JACKSON, TN 38301-5279
Phone number: 731-427-7238
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