| NPI | 1902010796 |
|---|---|
| Former Name | LOUISE RUSSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY RP035243) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NJ 44SC01433300) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-07-08 |