Individual provider · Type 1 NPI
Connie Russell, CSAC
Addiction (Substance Use Disorder) Counselor · Kenosha, WI
NPI number
1447691167
Active
Practice location
712 55th St
Kenosha, WI 53140-6506
Mailing address
5407 8th Ave
Kenosha, WI 53140-3715
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 1915-132 (WI) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
2 other providers at this address
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About NPI 1447691167
Connie Russell, CSAC's National Provider Identifier is 1447691167, issued on Jul 10, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Kenosha, WI. The record was last updated on Jul 11, 2013.