Individual
MS. MICHELLE A.C. RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
8147 RUTHERFORD DR, WOODRIDGE, IL 60517-8050
(331) 903-7931
Mailing address
8147 RUTHERFORD DR, WOODRIDGE, IL 60517-8050
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
12145
IL
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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