Individual
SARAH MICHELE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
3695 KIDS LN, MURRELLS INLET, SC 29576-4901
(843) 450-0295
Mailing address
PO BOX 724, 3695 KIDS LANE, MURRELLS INLET, SC 29576-0724
(843) 450-0295
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14374
SC
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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