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Bryan Russell
Peer Specialist in Grove, Oklahoma
NPI 1750820569

Bryan Russell is a Peer Specialist based in Grove, OK. Bryan Russell practices in Grove, OK. The NPI Number for Bryan Russell is 1750820569 and holds a License No. (Oklahoma).

The current practice location address for Bryan Russell is 32300 S 625 Rd, Grove, OK and can be reached out via phone at 918-786-2930 and via fax at 918-786-5985.

Location: 32300 S 625 Rd, Grove, OK, 74345-1585
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1750820569
Provider Name
Bryan Russell
Credential
Provider Entity Type
Individual
Gender
Male
Address
32300 S 625 Rd, Grove, OK, 74345-1585
Phone Number
918-786-2930
Fax Number
918-786-5985
Provider Enumeration Date
02/14/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
32300 S 625 Rd
City
Grove
State
Oklahoma
Zip
74344-6285
Phone Number
918-786-2930
Fax Number
918-786-5985
person
Provider Business Mailing Address Details
Address
32300 S 625 Rd
City
Grove
State
Oklahoma
Zip
74344-6285
Phone Number
918-786-2930
Fax Number
918-786-5985
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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