Individual
MRS. ALISON MARY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA-SLP
Contact information
Practice address
2141 GREENCREST WAY, LANCASTER, OH 43130-7591
(740) 687-7330
Mailing address
2141 GREENCREST WAY, LANCASTER, OH 43130-7591
(740) 687-7330
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP.13593
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP.13593
OHIO STATE LICENSE
OH
Enumeration date
10/11/2019
Last updated
10/11/2019
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