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General NPI Number Information
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NPI Number | 1700702263
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Entity Type | Individual
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Provider Name | JULIA MARIE RUSS MS
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Gender | Female
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Dates
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Enumeration Date | 06/27/2026
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Last Update Date | 06/27/2026
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Provider Practice Location Address
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Address Line | 6737 W WASHINGTON ST STE 2275
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City | WEST ALLIS
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State | WI
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Zip | 53214-5666
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Country | US
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Telephone | 414-309-6190
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Fax | 414-246-2302
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Provider Business Mailing Address
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Address Line | 1065 PRIMROSE LN
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City | FOND DU LAC
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State | WI
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Zip | 54935-1800
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 6993-154
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License Number State | WI
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