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1235412107
CHRISTOPHER J RUSSO
PROVIDENCE, RI
NPI
1235412107
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: RI CSW01400)
Enumeration Date
2011-09-27
Last Update Date
2013-10-10
Business Address
Mr. CHRISTOPHER J RUSSO LICSW
49 PAVILION AVE SUITE 105
PROVIDENCE, RI 02905-1534
Phone number: 401-490-8900
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Mailing Address
Mr. CHRISTOPHER J RUSSO LICSW
49 PAVILION AVE SUITE 105
PROVIDENCE, RI 02905-1534
Phone number: 401-490-8900
Copy
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