Individual
JACLYN RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
35575 DETROIT RD, AVON, OH 44011-1639
(440) 937-9660
Mailing address
35575 DETROIT RD, AVON, OH 44011-1639
(440) 937-9660
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2014260
OH
Other
Enumeration date
05/26/2014
Last updated
07/21/2022
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