Individual
MRS. AUTUMN DELLO RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4612 ROSEVILLE RD, SUITE 107, NORTH HIGHLANDS, CA 95660-5175
(916) 344-0199
(916) 344-0196
Mailing address
2624 KANSAS WAY, SACRAMENTO, CA 95827-1019
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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