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Individual

MIRANDA JO RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CCC-SLP

Contact information

Practice address
6900 N DURANGO DR, LAS VEGAS, NV 89149-4409
(702) 703-8608
Mailing address
7832 MONTOUR FALLS ST, LAS VEGAS, NV 89149-0117
(607) 354-6020

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-2890
NV

Other

Enumeration date
04/13/2023
Last updated
04/13/2023
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