Male or Other

Matthew D. Russell ABA

Behavioral Analyst in Grand Forks, ND(View on Map)

Full Name

Matthew David Russell ABA

NPI Number

1477045326

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/05/2018

Specialties

(Taxonomies)

Code

103K00000X

Primary Taxonomy

Yes

Licenses

State

North Dakota

License Number

L29

Contact
Information

Purpose

Mailing
Location

Address

151 S 4TH ST STE 401
151 S 4TH ST STE 401

City

Grand Forks
Grand Forks

State

ND
ND

Postal Code

58201-4715
58201-4715

Country

US
US

Telephone Number

(701) 795-3000
(701) 795-3000

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/05/2018

Provider Address

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