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1942861547
RUSSELL ELLIOTT
TYLER, TX
NPI
1942861547
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: TX 60332)
Enumeration Date
2019-06-25
Last Update Date
2019-06-25
Business Address
RUSSELL ELLIOTT LCSW
18051 FM 2015
TYLER, TX 75706-3130
Phone number: 308-430-8087
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Mailing Address
RUSSELL ELLIOTT LCSW
18051 FM 2015
TYLER, TX 75706-3130
Phone number: 308-430-2584
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