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1114202322
NICHOLAS RUSSI
NORTHRIDGE, CA
NPI
1114202322
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2011-10-19
Last Update Date
2015-04-09
Business Address
-- NICHOLAS RUSSI
18417 NORDHOFF ST STE D
NORTHRIDGE, CA 91325-2276
Phone number: 818-734-2761
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Mailing Address
-- NICHOLAS RUSSI
18417 NORDHOFF ST STE D
NORTHRIDGE, CA 91325-2276
Phone number: 818-734-2761
Copy
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