Individual
VICTORIA RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
17 TANNERY HILL DR, HAMBURG, NJ 07419-1236
(973) 600-1407
Mailing address
17 TANNERY HILL DR, HAMBURG, NJ 07419-1236
(973) 600-1407
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008868-1
NY
Other
Enumeration date
04/26/2017
Last updated
04/26/2017
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