SANDTRICE RUSSELL

FAIRBURN, GA
NPI1578007803
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YP2500X Counselor Professional
(Licence: GA  LPC009310)
Additional Taxonomies101Y00000X Counselor
(Licence: GA  LPC009310)
101YM0800X Counselor Mental Health
(Licence: GA  LPC009310)
Enumeration Date2016-12-06
Last Update Date2016-12-06
Business Address
SANDTRICE RUSSELL LPC
7117 WALTON HL
FAIRBURN, GA 30213-7112
Phone number: 404-924-5560
Mailing Address
SANDTRICE RUSSELL LPC
203 VINE ST
LAGRANGE, GA 30241-3346
Phone number: 404-924-5560