Samantha Leeann Russell

NPI #1912667874 in Harrison, Michigan

Provider Information

NPI Number: 1912667874
Entity Type: Individual
Name: Samantha Leeann Russell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 20, 2021
Last Updated: Dec 20, 2021

Practice Location

Address: 303 E SPRUCE ST
City: Harrison
State: Michigan
ZIP Code: 48625-8149
Phone: (989) 339-8655

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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