Individual
BEATA RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, OTR/L
Contact information
Practice address
561 KING ST, SOUTH WINDSOR, CT 06074
(860) 969-0207
Mailing address
850 CLARK ST UNIT 1382, SOUTH WINDSOR, CT 06074-7755
(860) 969-0207
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
002840
CT
225XH1200X
Hand Occupational Therapist
—
—
Other
Enumeration date
01/14/2010
Last updated
06/17/2020
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