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1043925845
MYKAYLA RUSSELL
FORT WAYNE, IN
NPI
1043925845
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-01-17
Last Update Date
2023-01-17
Business Address
MYKAYLA RUSSELL
201 E RUDISILL BLVD STE 100B
FORT WAYNE, IN 46806-1756
Phone number: 219-301-0774
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Mailing Address
MYKAYLA RUSSELL
201 E RUDISILL BLVD STE 100B
FORT WAYNE, IN 46806-1756
Phone number:
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