Russell, Mary

Russell, Mary is an individual health care provider with primary practice located at 110 Mccowat St , Jackson TN 38301-5279. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Russell, Mary can be contacted via phone (731) 427-7238.

Contact Information

Primary practice address
110 Mccowat St Jackson TN 38301-5279
Phone: (731) 427-7238
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LDC0000000502 Tennessee

Profile Details

NPI number 1508321423
LBN Legal business name Russell, Mary
Credentials MSW, LADACII
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2019
Last updated Feb 5th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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