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1053174557
ISAIAH FRANKLYN EUGENE RUSSELL
SAN JOSE, CA
NPI
1053174557
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA RBT-23-316556)
Enumeration Date
2024-02-06
Last Update Date
2024-02-06
Business Address
ISAIAH FRANKLYN EUGENE RUSSELL
1835 PARK AVE # 3
SAN JOSE, CA 95126-1629
Phone number: 408-318-3084
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Mailing Address
ISAIAH FRANKLYN EUGENE RUSSELL
300 INTERNATIONAL PKWY STE 200
LAKE MARY, FL 32746-5028
Phone number: 866-610-0580
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