Individual
MR. JAREL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD, OTR/L
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(213) 948-9556
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(213) 948-9556
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
20116
CA
225X00000X
Occupational Therapist
Primary
OT-2951
NV
Other
Enumeration date
06/19/2019
Last updated
04/11/2025
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