Individual
ASHLYN MARIE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75 GRAND AVE, MASSAPEQUA, NY 11758-4905
(516) 799-3203
Mailing address
27 VILLAS CIR, MELVILLE, NY 11747-3052
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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