Individual
LEEZAE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 33RD AVE, SAN FRANCISCO, CA 94121-3428
(415) 668-0190
Mailing address
750 33RD AVE, SAN FRANCISCO, CA 94121-3428
(415) 668-0190
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
03/31/2025
Last updated
04/30/2025
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