Individual
DEANDRA RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC/SP
Contact information
Practice address
121 CASEY ST STE A, CAMPBELLSVILLE, KY 42718-6858
(270) 465-7768
(270) 465-0068
Mailing address
620 W ASHLAND AVE, LOUISVILLE, KY 40215-2402
(606) 547-5561
(270) 465-0068
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12087
KY
Other
Enumeration date
01/23/2013
Last updated
01/23/2013
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