Individual
NATASHA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5542 BIG SEA ST, LAS VEGAS, NV 89110-4937
(614) 735-0813
Mailing address
5542 BIG SEA ST, LAS VEGAS, NV 89110-4937
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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