MR. Larry Wayne Russell, LSW MA

NPI #1588765614 in Webster Springs, West Virginia

Provider Information

NPI Number: 1588765614
Entity Type: Individual
Name: MR. Larry Wayne Russell, LSW MA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LSW MA
Enumeration Date: Sep 25, 2006
Last Updated: Aug 8, 2008

Practice Location

Address: 70 PARCOAL RD
City: Webster Springs
State: West Virginia
ZIP Code: 26288-9767
Phone: (304) 847-5425

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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