Individual
DAVID D RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATP, CRTS
Taxonomy
Speciality
Code
Description
License number
State
225CA2500X
Assistive Technology Supplier Rehabilitation Counselor
ATP 4124
—
247200000X
Other Technician
Primary
ATP 4124
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1008965
CRTS
—
01
—
4124
ATP
—
Enumeration date
04/05/2011
Last updated
04/27/2011
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