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1811674005
BRANDON RUSSELL
SACRAMENTO, CA
NPI
1811674005
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA r1510890623)
Enumeration Date
2023-06-29
Last Update Date
2023-06-29
Business Address
BRANDON RUSSELL
500 22ND ST
SACRAMENTO, CA 95816-3503
Phone number: 209-748-2470
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Mailing Address
BRANDON RUSSELL
500 22ND ST
SACRAMENTO, CA 95816-3503
Phone number:
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