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1710101209
ALISA RUSSELL
CONCORD, NC
NPI
1710101209
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NC 2008)
Enumeration Date
2007-04-13
Last Update Date
2007-07-08
Business Address
-- ALISA RUSSELL M.S.
15 SPENCER AVE NW
CONCORD, NC 28025-4316
Phone number: 704-795-7600
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Mailing Address
-- ALISA RUSSELL M.S.
PO BOX 1298
CONCORD, NC 28026-1298
Phone number:
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