Individual
CARRIE ANNE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
630 S WICKHAM RD STE 107, WEST MELBOURNE, FL 32904-1429
(321) 608-0604
Mailing address
1181 PALO ALTO ST SE, PALM BAY, FL 32909-7208
(401) 602-8412
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
FL
Other
Enumeration date
04/08/2026
Last updated
04/08/2026
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