Individual
JAMESON PARKER RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1313 DICKERSON DR SE APT D, ALBUQUERQUE, NM 87106-3344
(865) 226-9693
Mailing address
1313 DICKERSON DR SE APT D, ALBUQUERQUE, NM 87106-3344
(865) 226-9693
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/14/2022
Last updated
12/15/2022
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