TABATHA RUSSELL

LA FAYETTE, GA
NPI1851827257
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy251S00000X Community/Behavioral Health
Enumeration Date2017-05-04
Last Update Date2017-05-04
Business Address
-- TABATHA RUSSELL
212 BANDY RD
LA FAYETTE, GA 30728-4334
Phone number: 423-991-0034
Mailing Address
-- TABATHA RUSSELL
212 BANDY RD
LA FAYETTE, GA 30728-4334
Phone number:
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