Individual
ELDON RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
810 CENTRAL AVE, HUMBOLDT, NE 68376-6111
(402) 862-2151
Mailing address
1649 61ST ST, BROOKLYN, NY 11204-2746
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
04/23/2025
Last updated
12/08/2025
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