Individual
MS. BRANDY M RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
11501 SUNRISE VALLEY DR STE 200, RESTON, VA 20191-1505
(571) 494-8100
Mailing address
11322 EDENDERRY DR, FAIRFAX, VA 22030-5441
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
05601
MD
235Z00000X
Speech-Language Pathologist
Primary
2202005062
VA
Other
Enumeration date
09/30/2007
Last updated
09/12/2025
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