Samantha Jodi Russell

NPI #1851965487 in Menifee, California

Provider Information

NPI Number: 1851965487
Entity Type: Individual
Name: Samantha Jodi Russell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 18, 2021
Last Updated: May 18, 2021

Practice Location

Address: 29564 AVIDA DR
City: Menifee
State: California
ZIP Code: 92584-8610
Phone: (951) 452-1417

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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