Individual
RUSSELL BLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3277 S CRATER RD STE D, PETERSBURG, VA 23805-9285
(301) 752-4611
Mailing address
1331 GERMAN SCHOOL RD APT 201, RICHMOND, VA 23225-4192
(301) 752-4611
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
VA
171M00000X
Case Manager/Care Coordinator
—
VA
172V00000X
Community Health Worker
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8HUZ2
8HUZ2
VA
Enumeration date
12/27/2025
Last updated
12/27/2025
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