Diane G Russell Therapy Services LLC

NPI #1184969719 in Northville, Michigan

Provider Information

NPI Number: 1184969719
Entity Type: Organization
Organization Name: Diane G Russell Therapy Services LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Dec 7, 2012
Last Updated: Dec 7, 2012

Practice Location

Address: 640 GRISWOLD ST
Address 2: SUITE 300
City: Northville
State: Michigan
ZIP Code: 48167-1690
Phone: (248) 996-5383

Authorized Official

Name: MRS. DIANE G RUSSELL, LMSW
Title: SOCIAL WORKER
Phone: (248) 996-5383

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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