Individual
STEPHANIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21505 N 78TH AVE, 125, PEORIA, AZ 85382-3356
(603) 535-8341
Mailing address
801 E CAMELBACK RD, PHOENIX, AZ 85014-3660
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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