Organization · NPI-2

Anna M Russell Lcsw PC

Social Worker, Clinical · Cheyenne, WY

NPI number1659560225
StatusActive
Last updated in NPPESNov 13, 2007

Details

NPI
1659560225
Entity type
Organization (NPI-2)
Legal business name
Anna M Russell Lcsw PC
Organization subpart
No
Enumeration date
Oct 19, 2007
Last updated
Nov 13, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical231WYYes

Practice location

2909 Bent Ave
Cheyenne, WY 82001-2742

Phone 307-634-6594

Mailing address

2909 Bent Ave
Cheyenne, WY 82001-2742

Phone 307-634-6495

Authorized official

Anna M Russell
Owner
3076346594

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