Individual
MARLA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22601 CAMINO DEL MAR, BOCA RATON, FL 33433-6516
(561) 544-6288
Mailing address
13807 CRESTON PL, WELLINGTON, FL 33414-2157
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11509
FL
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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