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Individual

TAMARA RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2580 LINDO COURT, SUMTER, SC 29154
(803) 905-4427
(803) 905-4431
Mailing address
PO BOX 51322, BOWLING GREEN, KY 42102-5622
(270) 777-9283
(270) 777-9283

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-09-3568
SC

Other

Enumeration date
02/05/2009
Last updated
02/03/2016
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