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1235697046
DEZIRAE LOUISE RUSSO
KENTWOOD, MI
NPI
1235697046
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-03-11
Last Update Date
2019-03-11
Business Address
DEZIRAE LOUISE RUSSO
3361 36TH ST SE
KENTWOOD, MI 49512-2809
Phone number: 616-942-2522
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Mailing Address
DEZIRAE LOUISE RUSSO
4664 LAMPLIGHT LN SE APT 4
GRAND RAPIDS, MI 49546-6388
Phone number:
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