| NPI | 1679959381 |
|---|---|
| Former Name | CASSIDEE ANN RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL60700286) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WA SI60590508) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2019-01-21 |