Individual
BRITTANY SHANNON RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
450 SEAVIEW AVE, STATEN ISLAND, NY 10305-3401
(718) 226-6559
Mailing address
450 SEAVIEW AVE, STATEN ISLAND, NY 10305-3401
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
113314
NY
Other
Enumeration date
09/29/2021
Last updated
09/10/2024
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