# BEATA RUSSO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1104157148
- **Gender:** F
- **Credential:** M.ED, OTR/L

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 002840 | CT | Yes |
| 225XH1200X | Hand Occupational Therapist | — | NULL | — |
| 225XH1200X | Hand Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 01/14/2010
- **Last updated:** 06/17/2020