Individual
GAIL RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4 TIMOTHY RD, WAYNE, NJ 07470-4517
(518) 573-1345
(973) 406-7396
Mailing address
4 TIMOTHY RD, WAYNE, NJ 07470-4517
(518) 573-1345
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC06253000
NJ
1041C0700X
Clinical Social Worker
R016254
NY
Other
Enumeration date
10/25/2006
Last updated
03/29/2024
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