Individual
DR. JILLIAN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
115 MILL ST, BELMONT, MA 02478-1048
(617) 855-3900
Mailing address
115 MILL ST, BELMONT, MA 02478-1048
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
10434
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/28/2013
Last updated
06/30/2021
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