Individual
SHAWNTERRA MARIE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12608 GRIMSBY AVE, CLEVELAND, OH 44135-4850
(330) 490-9395
Mailing address
12608 GRIMSBY AVE, CLEVELAND, OH 44135-4850
(216) 780-0251
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.006787
OH
372600000X
Adult Companion
—
—
Other
Enumeration date
04/01/2024
Last updated
09/16/2025
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