Individual
ELIZABETH ANN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT GRAD.
Contact information
Practice address
3915 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4249
(763) 588-0811
(763) 520-0355
Mailing address
3915 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4249
(763) 588-0811
(763) 520-0355
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103686 (TEMP)
MN
Other
Enumeration date
01/28/2009
Last updated
01/28/2009
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