Individual
RUSSELL WAYNE FALLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1941 S 42ND ST STE 210, OMAHA, NE 68105-2946
(402) 341-6220
Mailing address
124 N 38TH AVE APT 1, OMAHA, NE 68131-2384
(573) 777-4076
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1106
NE
Other
Enumeration date
05/04/2021
Last updated
05/04/2021
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