Dr. Carl Lee Russell, M.A. DMin
Counselor, Professional in Albuquerque, NM. Individual provider (NPI-1).
NPI number1144690348
StatusActive
Last updated in NPPESNov 17, 2015
Details
- NPI
- 1144690348
- Entity type
- Individual (NPI-1)
- Name
- Dr. Carl Lee Russell
- Credential
- M.A. DMin
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 30, 2015
- Last updated
- Nov 17, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | T-0177631 | NM | Yes |
Practice location
2030 Moon St NeAlbuquerque, NM 87112-2709
Phone 505-298-7620
Mailing address
2030 Moon St NeAlbuquerque, NM 87112-2709
Phone 505-298-7620
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