Randa Russell, PRSS,QBHP

NPI #1104572320 in Fort Smith, Arkansas

Provider Information

NPI Number: 1104572320
Entity Type: Individual
Name: Randa Russell, PRSS,QBHP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Credential: PRSS,QBHP
Enumeration Date: Feb 25, 2022
Last Updated: Feb 25, 2022

Practice Location

Address: 3111 S 70TH ST
City: Fort Smith
State: Arkansas
ZIP Code: 72903-5017
Phone: (479) 452-6650

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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