NICOLE RUSSO

PHILADELPHIA, PA
NPI1235647314
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2018-01-11
Last Update Date2018-01-11
Business Address
NICOLE RUSSO
9815 ROOSEVELT BLVD
PHILADELPHIA, PA 19114-1035
Phone number: 616-644-6464
Mailing Address
NICOLE RUSSO
680 AMERICAN AVE
KING OF PRUSSIA, PA 19406-4023
Phone number: 616-644-6464