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1487993960
VINCENT RUSSO
BERKELEY, CA
NPI
1487993960
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-02-04
Last Update Date
2013-02-04
Business Address
Mr. VINCENT RUSSO CAADAC
1931 CENTER ST
BERKELEY, CA 94704-1105
Phone number: 916-742-0622
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Mailing Address
Mr. VINCENT RUSSO CAADAC
1931 CENTER ST
BERKELEY, CA 94704-1105
Phone number: 916-742-0622
Copy
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