Individual
MRS. JACQUELINE RUSSO STRAIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
255 S 17TH ST, SUITE 1307, PHILADELPHIA, PA 19103-6231
(267) 908-5292
Mailing address
255 S 17TH ST, SUITE 1307, PHILADELPHIA, PA 19103-6231
(267) 908-5292
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW016367
PA
Other
Enumeration date
10/31/2011
Last updated
12/11/2012
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