Individual
LATARSHA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
513 DONCASTER DR, IRMO, SC 29063-2525
(803) 201-2090
Mailing address
513 DONCASTER DR, IRMO, SC 29063-2525
(803) 201-2090
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
7126
SC
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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