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Joseph Donald Russom
Peer Specialist in Muskegon, Michigan
NPI 1356077911

Joseph Donald Russom is a Peer Specialist based in Grand Rapids, MI. Joseph Donald Russom practices in Muskegon, MI. The NPI Number for Joseph Donald Russom is 1356077911 and holds a License No. (Michigan).

The current practice location address for Joseph Donald Russom is 1221 Shonat St, Muskegon, MI and can be reached out via phone at 231-666-4443.

Location: 1221 Shonat St, Muskegon, MI, 49503-3849
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356077911
Provider Name
Joseph Donald Russom
Credential
Provider Entity Type
Individual
Gender
Male
Address
1221 Shonat St, Muskegon, MI, 49503-3849
Phone Number
231-666-4443
Fax Number
Provider Enumeration Date
07/26/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1221 Shonat St
City
Muskegon
State
Michigan
Zip
49442-5363
Phone Number
231-666-4443
Fax Number
person
Provider Business Mailing Address Details
Address
1221 Shonat St
City
Muskegon
State
Michigan
Zip
49442-5363
Phone Number
231-666-4443
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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