Individual
SHARANDA L RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5535 DOWNS WAY, LITHONIA, GA 30058-7853
(470) 640-4605
Mailing address
PO BOX 451331, ATLANTA, GA 31145-9331
(470) 640-4605
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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