Jonathan David Russell, SLP CLINICAL FELLOW
NPI #1689030124 in Thousand Oaks, California
Provider Information
- NPI Number
- 1689030124
- Entity Type
- Individual
- Name
- Jonathan David Russell, SLP CLINICAL FELLOW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Speech-Language Pathologist
- Credential
- SLP CLINICAL FELLOW
- Enumeration Date
- Jan 14, 2016
- Last Updated
- Jan 14, 2016
Practice Location
- Address
- 250 FAIRVIEW RD
- City
- Thousand Oaks
- State
- California
- ZIP Code
- 91361-2456
- Phone
- (888) 249-0707
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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