Individual
OLIVIA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 E WALNUT ST, THAYER, MO 65791-1533
(417) 264-4600
Mailing address
401 E WALNUT ST, THAYER, MO 65791-1533
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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