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1982970935
MARY M RUSSO
HOUMA, LA
NPI
1982970935
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
175T00000X Peer Specialist
Enumeration Date
2012-03-23
Last Update Date
2024-08-12
Business Address
MARY M RUSSO
420 MAGNOLIA ST
HOUMA, LA 70360-6304
Phone number: 985-879-3966
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Mailing Address
MARY M RUSSO
PO BOX 165
HOUMA, LA 70361-0165
Phone number: 985-879-3966
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