Individual
DANIELLE M RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
16 DAKIN AVE STE 110, MOUNT KISCO, NY 10549-2826
(516) 225-8767
Mailing address
16 DAKIN AVE STE 110, MOUNT KISCO, NY 10549-2826
(516) 225-8767
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
024364
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203368734
PLACE OF EMPLOYMENT
NY
Enumeration date
07/15/2014
Last updated
01/12/2025
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