Individual
BEYUNKA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 HIGHTOWER TRL STE B120, ATLANTA, GA 30350-6205
(866) 523-4268
Mailing address
PO BOX 399318, SAN FRANCISCO, CA 94139-9318
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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