Individual provider · Type 1 NPI

Jennifer Russell

Peer Specialist · Holdenville, OK

NPI number 1356061469 Active

Practice location

118 E Main St
Holdenville, OK 74848-3208

Call (405) 379-5256 Map

Mailing address

404 Oklahoma Ave
Wewoka, OK 74884-5088

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1356061469

Jennifer Russell's National Provider Identifier is 1356061469, issued on Aug 30, 2022. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Holdenville, OK. The record was last updated on Aug 30, 2022.