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MS. YVONNE MARIE RUSS CACII

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1922251933

Individual Registrant:
MS. YVONNE MARIE RUSS CACII
Gender: F
Sole Proprietor

Location and contact information for practice:
415 CLARK STREET  TALBOTTON, GA 31827 US
Tel: 706-573-1058  Fax: --

Contact information for business:
415 CLARK STREET P.O. BOX 717 TALBOTTON, GA 31827 US
Tel: 706-573-1058  Fax: --

Registration Information:
NPI: 1922251933
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
CERTIFIED ADDICTION COUNSELOR1628-RGA01




HEALTH CARE JOBS GA - Page 1



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