Raesha Russell

NPI #1912494006 in Clovis, New Mexico

Provider Information

NPI Number: 1912494006
Entity Type: Individual
Name: Raesha Russell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 16, 2018
Last Updated: Apr 16, 2018

Practice Location

Address: 214 WEST 9TH ST
City: Clovis
State: New Mexico
ZIP Code: 88101
Phone: (575) 218-1769

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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