Individual
REBECCA SUZANNE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
5025 LAKIN DR, CATLETTSBURG, KY 41129-9152
(606) 931-0236
Mailing address
5025 LAKIN DR, CATLETTSBURG, KY 41129-9152
(606) 931-0236
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
KY-1953
KY
Other
Enumeration date
07/11/2009
Last updated
07/11/2009
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