Shanyta Russell

NPI #1124396825 in Flossmoor, Illinois

Provider Information

NPI Number: 1124396825
Entity Type: Individual
Name: Shanyta Russell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Analyst
Enumeration Date: Dec 8, 2011
Last Updated: Dec 8, 2011

Practice Location

Address: 19530 KEDZIE AVE
City: Flossmoor
State: Illinois
ZIP Code: 60422-1778
Phone: (708) 799-2200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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