Individual
TIERAH RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2911 LEISURE WOODS LN, DECATUR, GA 30034-3430
(404) 834-1735
Mailing address
2911 LEISURE WOODS LN, DECATUR, GA 30034-3430
(404) 834-1735
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
—
—
172A00000X
Driver
—
—
174H00000X
Health Educator
—
—
175L00000X
Homeopath
—
—
372500000X
Chore Provider
—
—
374U00000X
Home Health Aide
Primary
—
—
376G00000X
Nursing Home Administrator
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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