Individual
CASEY RUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED. BCBA LBA
Contact information
Practice address
2338 W ROYAL PALM RD STE J, PHOENIX, AZ 85021-9339
(269) 612-7261
(480) 522-3713
Mailing address
2338 W ROYAL PALM RD STE J, PHOENIX, AZ 85021-9339
(269) 612-7261
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA-0270
AZ
Other
Enumeration date
07/16/2015
Last updated
10/16/2024
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