Jennifer Anne Russell, MFT Intern
Marriage & Family Therapist in Sacramento, CA. Individual provider (NPI-1).
NPI number1780973263
StatusActive
Last updated in NPPESApr 6, 2011
Details
- NPI
- 1780973263
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Anne Russell
- Credential
- MFT Intern
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 5, 2011
- Last updated
- Apr 6, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | imf63783 | CA | Yes |
Practice location
5777 Madison Ave Ste 240Sacramento, CA 95841-3308
Phone 916-239-6315
Mailing address
5777 Madison Ave Ste 240Sacramento, CA 95841-3308
Phone 916-239-6315
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