KELLY L RUSSO

ORANGEBURG, SC
NPI1265664734
Former NameKELLY L DAVIS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist Clinical
(Licence: FL  PY-8336)
Enumeration Date2009-08-18
Last Update Date2014-05-01
Business Address
DR. KELLY L RUSSO PH.D.
1767 VILLAGE PARK DR
ORANGEBURG, SC 29118-2475
Phone number: 803-776-4000
Mailing Address
DR. KELLY L RUSSO PH.D.
715 DARLINGTON ST
COLUMBIA, SC 29201-1201
Phone number: 239-314-8511
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