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1225037575
JOAN CAROL RUSSO
OCONOMOWOC, WI
NPI
1225037575
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: WI 1169)
Enumeration Date
2005-07-19
Last Update Date
2014-07-07
Business Address
-- JOAN CAROL RUSSO Ph.D.
W340N6509 BREEZY POINT RD
OCONOMOWOC, WI 53066-5132
Phone number: 262-490-9114
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Mailing Address
-- JOAN CAROL RUSSO Ph.D.
W340N6509 BREEZY POINT RD
OCONOMOWOC, WI 53066-5132
Phone number: 262-490-9114
Copy
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