Latasha Nicole Russell
NPI #1386932507 in Tarzana, California
Provider Information
- NPI Number
- 1386932507
- Entity Type
- Individual
- Name
- Latasha Nicole Russell
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Professional
- Enumeration Date
- Jul 21, 2011
- Last Updated
- Jun 25, 2013
Practice Location
- Address
- 18646 OXNARD ST
- Address 2
- TARZANA TREATMENT CENTERS
- City
- Tarzana
- State
- California
- ZIP Code
- 91356-1411
- Phone
- (818) 996-1051
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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