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1053405100
RICHARD LOUIS RUSSO
MADISON, WI
NPI
1053405100
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WI 1384-123)
Enumeration Date
2006-10-03
Last Update Date
2007-07-08
Business Address
Mr. RICHARD LOUIS RUSSO LCSW
1400 E WASHINGTON AVE SUITE 187
MADISON, WI 53703-3041
Phone number: 608-251-0839
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Mailing Address
Mr. RICHARD LOUIS RUSSO LCSW
1400 E WASHINGTON AVE SUITE 187
MADISON, WI 53703-3041
Phone number: 608-251-0839
Copy
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