Individual
MADISON RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23247 I 30 UNIT 7, BRYANT, AR 72022-2571
(501) 313-0592
Mailing address
1505 DEL REY CT, BENTON, AR 72019-6002
(870) 904-5934
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
202849
AR
Other
Enumeration date
08/09/2023
Last updated
09/29/2025
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