Individual
MR. KYLE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LCMHC
Contact information
Practice address
9 CEDARWOOD DR UNIT 10, BEDFORD, NH 03110-6801
(603) 255-3877
Mailing address
2 WALL ST STE 300, MANCHESTER, NH 03101-1518
(603) 668-4111
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
01/09/2019
Last updated
11/05/2024
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