Dayle Russell

NPI #1295920395 in West Frankfort, Illinois

Provider Information

NPI Number
1295920395
Entity Type
Individual
Name
Dayle Russell
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Developmental Therapist
Enumeration Date
Sep 11, 2007
Last Updated
Sep 11, 2007

Practice Location

Address
902 W MAIN ST
ZIP Code
62896-2210
Phone
(618) 937-6483

Specialties & Taxonomy Codes

Specialty
Developmental Therapist

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