Individual
JILLIAN MARIE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
4401 OLD AIRPORT RD, CONCORD, NC 28025-7188
(704) 933-3781
Mailing address
1584 DARTMOOR AVE NW, CONCORD, NC 28027-3588
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6742
NC
Other
Enumeration date
03/13/2012
Last updated
04/23/2026
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