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1619115557
ANDREA M RUSSELL
O FALLON, IL
NPI
1619115557
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: IL 146.009661)
Enumeration Date
2009-01-30
Last Update Date
2009-01-30
Business Address
-- ANDREA M RUSSELL MS, CCC-SLP
634 N MAIN ST SUITE 3
O FALLON, IL 62269-3733
Phone number: 618-632-4222
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Mailing Address
-- ANDREA M RUSSELL MS, CCC-SLP
634 N MAIN ST SUITE 3
O FALLON, IL 62269-3733
Phone number: 618-632-4222
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