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Individual

REBECCA RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
70 SCOTT DR, BATESVILLE, AR 72501-9796
(870) 251-2341
(870) 251-3316
Mailing address
70 SCOTT DR, BATESVILLE, AR 72501-9796
(870) 251-2341
(870) 251-3316

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#1435
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
136394721
AR
Enumeration date
07/31/2008
Last updated
07/31/2008
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