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Organization

GENA RUSSO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GENA HOPE RUSSO LCSW (LICSENSED CLINICAL SOCIAL WORKER)
(860) 874-7149
Entity
Organization

Contact information

Practice address
2984 S WABASH ST, DENVER, CO 80231-4223
(860) 874-7149
Mailing address
2984 S WABASH ST, DENVER, CO 80231-4223
(860) 874-7149

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1957
CO

Other

Enumeration date
02/15/2012
Last updated
02/15/2012
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