Marissa Russell

NPI #1033576293 in Mount Dora, Florida

Provider Information

NPI Number: 1033576293
Entity Type: Individual
Name: Marissa Russell
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Analyst
Enumeration Date: Jan 19, 2016
Last Updated: Jan 19, 2016

Practice Location

Address: 1335 E 3RD AVE
City: Mount Dora
State: Florida
ZIP Code: 32757-5837
Phone: (407) 415-4712

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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