Jeremy K Russell, M.A., QMHP
NPI #1396923074 in Cottage Grove, Oregon
Provider Information
- NPI Number
- 1396923074
- Entity Type
- Individual
- Name
- Jeremy K Russell, M.A., QMHP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Mental Health
- Credential
- M.A., QMHP
- Enumeration Date
- Feb 5, 2008
- Last Updated
- Feb 5, 2008
Practice Location
- Address
- 410 N 9TH ST
- City
- Cottage Grove
- State
- Oregon
- ZIP Code
- 97424-1307
- Phone
- (541) 942-2850
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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