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Individual

CARLA RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9001 PORTAGE POINTE DR APT F112, STREETSBORO, OH 44241-6328
(330) 282-2828
Mailing address
9001 PORTAGE POINTE DR APT F112, STREETSBORO, OH 44241-6328
(330) 282-2828

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
07/13/2022
Last updated
07/13/2022
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