Russell O Gillette, LPC, LADC

NPI #1497057558 in Tahlequah, Oklahoma

Provider Information

NPI Number
1497057558
Entity Type
Individual
Name
Russell O Gillette, LPC, LADC
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Counselor - Professional
Credential
LPC, LADC
Enumeration Date
Nov 23, 2010
Last Updated
Nov 23, 2010

Practice Location

Address
1008 S MUSKOGEE AVE
ZIP Code
74464-4734
Phone
(918) 458-0113

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)
Counselor - ProfessionalProfessional

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