| Doctor Name: | DEANDRA RUSS |
| NPI Number: | 1831437060 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, CCC/SP |
| License Number: | 12087 |
| Business Practice Address: | 121 Casey St Ste A Campbellsville, KY - 427186858 |
| Business Phone Number: | 2704657768 |
| Business Fax Number: | 2704650068 |
| Mailing Address: | 620 W Ashland Ave, LOUISVILLE |
| State: | KY |
| Postal Code: | 402152402 |
| Phone Number: | 6065475561 |
| Fax Number: | 2704650068 |
| NPI Enumeration Date: | 01/23/2013 |
| NPI Last Update Date: | 01/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 12087 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |