Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andrea Russell

Organization Developmental Therapist · NPI 1104769520

Andrea Russell is a Developmental Therapist in Rigby, Idaho. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
2

Practice location Address checks out

1200 Jaylee Dr Unit 1
Rigby, ID 83442-5273
Phone: (208) 419-9383
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X
Developmental Therapist Taxonomy 222Q00000X

Record details

NPI number1104769520
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrea Russell — Intervention Professional · (208) 419-9383
NPI enumeratedApril 10, 2026
Last updated in NPPESMay 13, 2026
Certification dateMay 13, 2026
Mailing address1200 Jaylee Dr Unit 1, Rigby, ID 83442-5273