Individual
EMILY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
265 S HARLAN ST # 80226, LAKEWOOD, CO 80226-2261
(831) 345-4239
Mailing address
265 S HARLAN ST # 80226, LAKEWOOD, CO 80226-2261
(831) 345-4239
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
CO
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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