Individual
MS. KRISTINA LEA RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. L.M.H.C.
Contact information
Practice address
10 MEADOWBROOK RD, BROCKTON, MA 02301-7122
(508) 742-4400
(508) 408-6192
Mailing address
10 MEADOWBROOK RD, BROCKTON, MA 02301-7122
(508) 742-4400
(508) 408-6192
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5692
MA
Other
Enumeration date
10/25/2010
Last updated
06/08/2016
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