Individual
AMBER RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
6478 W WAHALLA LN, GLENDALE, AZ 85308-7078
(623) 980-0357
Mailing address
6478 W WAHALLA LN, GLENDALE, AZ 85308-7078
(623) 980-0357
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA10314
AZ
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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