Individual
HAILEY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2850 UNIVERSAL ST, OSHKOSH, WI 54904-8975
(920) 267-8350
(920) 238-3339
Mailing address
2850 UNIVERSAL ST, OSHKOSH, WI 54904-8975
(920) 267-8350
(920) 238-3339
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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