Tabatha Russell
NPI #1851827257 in La Fayette, Georgia
Provider Information
- NPI Number
- 1851827257
- Entity Type
- Individual
- Name
- Tabatha Russell
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- May 4, 2017
- Last Updated
- May 4, 2017
Practice Location
- Address
- 212 BANDY RD
- City
- La Fayette
- State
- Georgia
- ZIP Code
- 30728-4334
- Phone
- (423) 991-0034
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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