Individual
SHERYL RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, IBCLC
Contact information
Practice address
2404 WILLOW ST, AUSTIN, TX 78702-5628
(512) 482-0773
Mailing address
2404 WILLOW ST, AUSTIN, TX 78702-5628
(512) 482-0773
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-314633
TX
176B00000X
Midwife
99056
TX
Other
Enumeration date
03/05/2008
Last updated
01/20/2024
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