Individual
TONI J RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4302 E 500 N, RIGBY, ID 83442-5216
(208) 710-9049
Mailing address
4302 E 500 N, RIGBY, ID 83442-5216
(208) 710-9049
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/09/2025
Last updated
04/02/2026
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