Lisa Evealine Russell, HAB SPEC

NPI #1821614371 in Maxwelton, West Virginia

Provider Information

NPI Number
1821614371
Entity Type
Individual
Name
Lisa Evealine Russell, HAB SPEC
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Day Training/Habilitation Specialist
Credential
HAB SPEC
Enumeration Date
Jun 21, 2020
Last Updated
Jun 21, 2020

Practice Location

Address
804 INDUSTRIAL PARK RD
ZIP Code
24957-8066
Phone
(304) 497-0500

Specialties & Taxonomy Codes

Specialty
Day Training/Habilitation Specialist

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