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)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