Individual
MARY MARGARET RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CF-SLP
Contact information
Practice address
3162 W MARTIN LUTHER KING JR BLVD STE 4, FAYETTEVILLE, AR 72704-7679
(479) 435-6636
Mailing address
385 E DRAKE ST, FAYETTEVILLE, AR 72703-3345
(501) 454-5724
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
202232
AR
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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