Individual provider · Type 1 NPI

Mary Russell, MSW, LADACII

Addiction (Substance Use Disorder) Counselor · Jackson, TN

NPI number 1508321423 Active

About NPI 1508321423

Mary Russell, MSW, LADACII's National Provider Identifier is 1508321423, issued on Feb 5, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Jackson, TN. The record was last updated on Feb 5, 2019.