Individual
MS. STEFANIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
S.L.P.
Contact information
Practice address
6610 GULTON CT NE, ALBUQUERQUE, NM 87109-4407
(505) 508-0505
Mailing address
4509 SAN ANDRES AVE NE, ALBUQUERQUE, NM 87110-1125
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5269
NM
Other
Enumeration date
03/04/2013
Last updated
03/04/2013
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