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 |