NPI 1093029373

Jennie Lou Russell, LMSW

Practitioner Social Worker Shiprock, NM

Practice location

Address: US Hwy 491 North, Shiprock, NM 87420-0160
Phone: (505) 368-7280
Fax: (505) 368-6431
Mailing address: PO Box 160, Shiprock, NM 87420-0160

Registered specialties

Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 104100000X Licence M-04576 (NM)

Other Social Worker providers in New Mexico →

Registry record

NPI: 1093029373
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Jul 2010
Record last updated: 29 Jul 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.