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Individual

ERICA ASHLEY RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1080 SILVER LAKE BLVD, DOVER, DE 19904-2410
(410) 312-7631
(410) 510-1779
Mailing address
1080 SILVER LAKE BLVD, DOVER, DE 19904-2410
(410) 312-7631
(410) 510-1779

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
07558
MD
235Z00000X
Speech-Language Pathologist
Primary
O1-0001580
DE

Other

Enumeration date
06/18/2014
Last updated
07/21/2022
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