Individual
LEAH RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
161 FIELDSTONE LN, MADISON, MS 39110-5046
(225) 405-3907
Mailing address
161 FIELDSTONE LN, MADISON, MS 39110-5046
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3839
MS
Other
Enumeration date
10/08/2016
Last updated
10/08/2016
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