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NPI Code Detail

MEDICARE: AIMEE K RUSSEL

MEDICARE: AIMEE K RUSSEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2001013147MO

General Provider Information

NPI Number : 1922323591
Entity Type Code : Individual
Provider Name (Legal Business Name) : AIMEE K RUSSEL
Provider Business Mailing Address
First Line : 206 S RONEY ST
Second Line :
City : CARL JUNCTION
State : MO
Zip : 64834-9402
Country : US
Telephone Number : 417-649-7026
Fax Number : 417-649-6594
Provider Business Practice Location Address
First Line : 206 S RONEY ST
Second Line :
City : CARL JUNCTION
State : MO
Zip : 64834-9402
Country : US
Telephone Number : 417-649-7026
Fax Number : 417-649-6594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2010
Last Update Date : 04/07/2010

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Directions to “ AIMEE K RUSSEL ” Practice Location

Language Start Address Practice Location
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