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1285199935
STILLWELL RUSSELL
METAIRIE, LA
NPI
1285199935
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-02-06
Last Update Date
2022-07-18
Business Address
STILLWELL RUSSELL
4201 N I 10 SERVICE RD W
METAIRIE, LA 70006-6713
Phone number: 855-550-5308
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Mailing Address
STILLWELL RUSSELL
350 FAIRWAY DR STE 101
DEERFIELD BEACH, FL 33441-1834
Phone number: 877-418-2978
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