Individual
BRANDY L. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
426 BUSH RIVER RD, COLUMBIA, SC 29210-7312
(803) 335-0718
Mailing address
2230 LILIHA ST, HONOLULU, HI 96817-1646
(808) 586-3000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-80803
SC
224Z00000X
Occupational Therapy Assistant
OTA-198
HI
Other
Enumeration date
07/08/2019
Last updated
04/23/2025
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