Individual provider · Type 1 NPI
Laura Renay Russell, CMHC
Mental Health Counselor · South Jordan, UT
NPI number
1396377917
Active
Practice location
5414 Daybreak Pkwy, C-4 #123
South Jordan, UT 84009
Fax (385) 308-7477
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 10322316-6004 (UT) |
Mental Health Counselor: Definition to come...
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About NPI 1396377917
Laura Renay Russell, CMHC's National Provider Identifier is 1396377917, issued on Feb 11, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in South Jordan, UT. The record was last updated on Aug 14, 2023.