Individual
ASHAA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
434 MAIN ST, NEW ROCHELLE, NY 10801-6410
(914) 632-5400
Mailing address
590 E 3RD ST APT 2M, MOUNT VERNON, NY 10553-1822
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000050588
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/18/2017
Last updated
08/01/2022
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