Individual
JENNIFER RUSSOTIESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7900 CASS AVE, DARIEN, IL 60561-5073
(630) 884-8643
Mailing address
147 41ST ST, DOWNERS GROVE, IL 60515-2344
(312) 375-2707
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.014871
IL
Other
Enumeration date
01/14/2020
Last updated
01/05/2023
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