Individual
HANNAH LEIGH RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 BROADHOLLOW RD, MELVILLE, NY 11747-4822
(631) 385-7795
(631) 385-7795
Mailing address
5 PARK AVE, NESCONSET, NY 11767-1011
(631) 672-5287
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/04/2020
Last updated
09/04/2020
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