Individual
ABBY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9117 GLENARDEN PKWY, GLENARDEN, MD 20706-2672
(301) 332-4188
Mailing address
9117 GLENARDEN PKWY, GLENARDEN, MD 20706-2672
(301) 332-4188
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-303876
MD
Other
Enumeration date
10/12/2023
Last updated
02/13/2024
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