Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIFFANY T RUSSELL
Active Sole ProprietorIntellectual Disabilities Residential Treatment Facility · DRY FORK, VA
Registration Details
- NPI Number
- 1437026358
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 23, 2025 (0.49520807953571 yrs)
- Last Updated
- Oct 24, 2025
- License
-
11862 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6245 DRY FORK RDDRY FORK, VA, 245494139Browse VA providers · Browse ZIP 24549
- Phone
- 4347100831
- Primary Specialty
-
Intellectual Disabilities Residential Treatment Facility
320600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.