Russell, Marsha T

Russell, Marsha T is an individual health care provider with primary practice located at 4977 Northcutt Pl , Dayton OH 45414-3839. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Russell, Marsha T can be contacted via phone (937) 387-6395.

Contact Information

Primary practice address
4977 Northcutt Pl Dayton OH 45414-3839
Phone: (937) 387-6395
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CDCA.173387 Ohio

Profile Details

NPI number 1003302613
LBN Legal business name Russell, Marsha T
Credentials CDCA
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2018
Last updated Sep 27th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003302613 NPPES
Ohio Other 1326012360 AGENCY NPI

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