WYATT RUSSOM
NPI 1609562883
Behavior Technician in Poplar Bluff, MO
About Wyatt Russom NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WYATT RUSSOM (NPI 1609562883) is an individual behavior technician in Poplar Bluff, Missouri and active in the NPI registry since April 2023.
NPPES Registry Identity
Specialties & Licenses
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Wyatt Russom's NPI number?
The NPI number for Wyatt Russom is 1609562883. It was assigned to this individual provider in the NPPES registry on April 12, 2023.
Where is Wyatt Russom located?
Wyatt Russom practices at 2995 Warrior Ln, Poplar Bluff, MO 63901. The listed phone number is (573) 712-2902.
What is Wyatt Russom's specialty?
The primary specialty registered for this NPI is Behavior Technician with taxonomy code 106S00000X.
When was this NPI record last updated?
The NPPES record for Wyatt Russom was last updated on April 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.