Individual
AUDREY M RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3435 W 96TH ST, INDIANAPOLIS, IN 46268-1102
(317) 802-7447
Mailing address
1824 TOUBY PIKE STE B, KOKOMO, IN 46901-2573
(765) 628-7400
(855) 940-0177
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/04/2013
Last updated
03/09/2022
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