Individual
ALISON BRIDGES RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
175 KIMEL PARK DR STE 100, WINSTON SALEM, NC 27103-6951
(336) 718-3550
(336) 277-1825
Mailing address
6180 PROVIDENCE CHURCH RD, WINSTON SALEM, NC 27105-8723
(336) 757-2501
(336) 277-4634
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C008996
NC
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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