Individual provider · Type 1 NPI

Mary Teisita Russell

Mental Health Counselor · Clinton, OK

NPI number 1043509573 Active

Practice location

70 N 31st St
Clinton, OK 73601-9116

Fax (580) 323-5635

Mailing address

618 N State St
Weatherford, OK 73096-3840

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1043509573

Mary Teisita Russell's National Provider Identifier is 1043509573, issued on Apr 5, 2011. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Clinton, OK. The record was last updated on Apr 5, 2011.