Individual
GILBERT RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
674 PROSPECT AVE, HARTFORD, CT 06105-4288
(860) 233-6228
(860) 233-2371
Mailing address
674 PROSPECT AVE, HARTFORD, CT 06105-4288
(860) 233-6228
(860) 233-2371
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001728
CT
Other
Enumeration date
10/15/2006
Last updated
07/08/2007
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