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1811478498
GARY ALLEN RUSSELL
LAFAYETTE, CO
NPI
1811478498
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-08-22
Last Update Date
2018-08-22
Business Address
Mr. GARY ALLEN RUSSELL
1455 DIXON AVE
LAFAYETTE, CO 80026-8879
Phone number: 720-406-3604
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Mailing Address
Mr. GARY ALLEN RUSSELL
1181 E 1ST AVE APT 1802
BROOMFIELD, CO 80020-3770
Phone number: 720-244-5003
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