Individual
JESSICA MARIE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24 ELIZABETH CT FL 1B-2, PLAINVILLE, CT 06062-2755
(203) 788-9874
Mailing address
24 ELIZABETH CT FL 1B-2, PLAINVILLE, CT 06062-2755
(203) 788-9874
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4715
CT
Other
Enumeration date
05/06/2019
Last updated
05/06/2019
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