Individual
MRS. CARRIE REID RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
7858 SHRADER ROAD, RICHMOND, VA 23294
(804) 270-1305
(804) 273-9294
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119000301
VA
Other
Enumeration date
04/26/2006
Last updated
01/19/2023
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