MISS Teki Mashawn Russell, OTR/L

NPI #1992196364 in Senoia, Georgia

Provider Information

NPI Number
1992196364
Entity Type
Individual
Name
MISS Teki Mashawn Russell, OTR/L
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Contractor
Credential
OTR/L
Enumeration Date
Feb 6, 2015
Last Updated
Jun 9, 2016

Practice Location

Address
444 CHESTLEHURST RD
City
Senoia
State
Georgia
ZIP Code
30276-2505
Phone
(770) 599-4500

Specialties & Taxonomy Codes

Specialty
Contractor

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