| NPI | 1104696855 |
|---|---|
| Former Name | ANNE-MARIE KRISTINE DERUSSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2024-01-04 |
| Last Update Date | 2024-09-30 |