Andrea Russell

NPI #1770342420 in Rigby, Idaho

Provider Information

NPI Number: 1770342420
Entity Type: Individual
Name: Andrea Russell
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Enumeration Date: Mar 15, 2024
Last Updated: May 11, 2025

Practice Location

Address: 1200 JAYLEE DR UNIT 1
City: Rigby
State: Idaho
ZIP Code: 83442-5273
Phone: (208) 419-9383

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community/Behavioral Health	251S00000X
Developmental Therapist	222Q00000X	Primary

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