Individual
MR. TERENCE P RUSSELL
Active
Individual
MR. TERENCE P RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
231HA2500X
Assistive Technology Supplier Audiologist
Primary
AU610
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AU610
CALIFORNIA AUDIOLOGY LICE
CA
01
—
HA1037
HEARING AID DISPENSER
CA
Enumeration date
02/01/2007
Last updated
01/25/2018
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