Individual
JAKEHA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5026 CHATTERTON RD APT 2, COLUMBUS, OH 43232-5875
(380) 245-4153
Mailing address
5026 CHATTERTON RD APT 2, COLUMBUS, OH 43232-5875
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/04/2024
Last updated
06/04/2024
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