MR. Thomas Charles Russell SR., SOCIAL WORK

NPI #1235957044 in Richfield, Utah

Provider Information

NPI Number: 1235957044
Entity Type: Individual
Name: MR. Thomas Charles Russell SR., SOCIAL WORK
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: SOCIAL WORK
Enumeration Date: Sep 30, 2024
Last Updated: Sep 30, 2024

Practice Location

Address: 449 N SR 118
City: Richfield
State: Utah
ZIP Code: 84701-2378
Phone: (435) 201-9389

Specialties & Taxonomy Codes

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

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