Tabby Jeane Russell
Individual provider Active NPI Developmentally Disabled Services Day Training Agency · Evansville, WY
NPI 1013213438 · NPPES record last updated Feb 2, 2011
Key facts
- NPI
- 1013213438
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmentally Disabled Services Day Training Agency 251C00000X
- Practice address
- 808 Silver Sage
Evansville, WY 82636-9532 - Phone
- (307) 251-2459
- NPI assigned
- Feb 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | Yes |
Addresses
Primary practice location
808 Silver Sage
Evansville, WY 82636-9532
Mailing address
808 Silver Sage
Evansville, WY 82636-9532
Phone (307) 251-2459
Other providers in Evansville, WY
- Shawn Michele McMillan
- Meadow Bloom Doula Care LLC
- Never Give Up Mental Health, LLC
- Mary E Opitz
- Psychiatric Mental Health Solutions
- Jennifer Ann Schumacher
- Kayci Stripling
- Maikou Thao
- Town of Evansville
- Uplift Therapy and Wellness LLC
All providers in Evansville, WY · Developmentally Disabled Services Day Training Agency in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.