Individual
VIRGINIA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUDIOLOGIST
Contact information
Practice address
733 N FLAG CHAPEL RD, MAGNOLIA SPEECH SCHOOL, JACKSON, MS 39209-2206
(601) 922-5530
(601) 922-5534
Mailing address
733 N FLAG CHAPEL RD, MAGNOLIA SPEECH SCHOOL, JACKSON, MS 39209-2206
(601) 922-5530
(601) 922-5534
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A2764
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02372704
—
MS
Enumeration date
10/09/2007
Last updated
10/09/2007
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