Provider Information for 1427667278
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VALERIE RUSSELL LCSW-A
Sex: Female
NPI: 1427667278
Last Updated: 2020-07-28
Certification Date: 2020-07-28
Certification Date: 2020-07-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1427667278 | ||||||||
| Enumeration Date | 2020-07-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6209 LAKEHAVEN DR FAYETTEVILLE, NC 28304-0610 United States Phone: 910-354-4831 | Fax: | ||||||||
| Primary Practice Address | 6209 LAKEHAVEN DR FAYETTEVILLE, NC 28304-0610 United States Phone: 910-354-4831 | Fax: | ||||||||
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