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1457072209
PHILIPPE RICHARD RUSSIAN
SOUTHLAKE, TX
NPI
1457072209
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: TX RBT-16-15039)
Enumeration Date
2022-09-09
Last Update Date
2022-09-09
Business Address
PHILIPPE RICHARD RUSSIAN
2104 GREENBRIAR DR
SOUTHLAKE, TX 76092-8355
Phone number: 817-442-9022
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Mailing Address
PHILIPPE RICHARD RUSSIAN
2104 GREENBRIAR DR
SOUTHLAKE, TX 76092-8355
Phone number:
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