Individual
MRS. KESHIA J RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD, CCC-SLP
Contact information
Practice address
1002 ELM STREET, DONIPHAN, MO 63935
(573) 996-3667
Mailing address
1002 ELM STREET, DONIPHAN, MO 63935
(573) 996-3667
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/13/2015
Last updated
08/11/2020
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