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1972193837
TARA BRYNN RUSSELL
AUSTIN, TX
NPI
1972193837
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: TX 64949)
Enumeration Date
2021-01-24
Last Update Date
2021-01-24
Business Address
TARA BRYNN RUSSELL LCSW
7708 PECCARY DR
AUSTIN, TX 78744-4470
Phone number: 541-788-3136
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Mailing Address
TARA BRYNN RUSSELL LCSW
7708 PECCARY DR
AUSTIN, TX 78744-4470
Phone number: 541-788-3136
Copy
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