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1982331823
LAURA GRACE RUSSELL
TARZANA, CA
NPI
1982331823
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-08-02
Last Update Date
2022-08-02
Business Address
LAURA GRACE RUSSELL
5554 RESEDA BLVD
TARZANA, CA 91356-2200
Phone number: 818-705-5522
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Mailing Address
LAURA GRACE RUSSELL
5554 RESEDA BLVD
TARZANA, CA 91356-2200
Phone number: 818-705-5522
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