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1891048906
RUSSELL C MULLETT
CHAMPAIGN, IL
NPI
1891048906
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 180.006850)
Enumeration Date
2012-10-26
Last Update Date
2012-10-26
Business Address
Mr. RUSSELL C MULLETT M.Ed., LCPC
1801 FOX DR
CHAMPAIGN, IL 61820-7236
Phone number: 217-693-4529
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Mailing Address
Mr. RUSSELL C MULLETT M.Ed., LCPC
543 S WASHINGTON ST
PAXTON, IL 60957-1663
Phone number: 217-722-0231
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