Individual
MARY JESSICA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
940 LOPEZ RD, LAS CRUCES, NM 88007-6806
(575) 499-9548
Mailing address
PO BOX 2131, MESILLA PARK, NM 88047-2131
(575) 499-9548
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
124148987
NM
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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