Individual
KYLIE AMBER RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
320 S AMES ST APT 1, LAKEWOOD, CO 80226-3658
(704) 996-5055
Mailing address
320 S AMES ST APT 1, LAKEWOOD, CO 80226-3658
(704) 996-5055
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6628
CO
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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