Individual
TRACEY R LEE-RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 COLISEUM ST, NEW ORLEANS, LA 70115-3606
(504) 644-2482
Mailing address
2428 AMY DR, LA PLACE, LA 70068-6267
(504) 939-7274
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/11/2018
Last updated
09/12/2023
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