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Individual

BERNADETTE RUSSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
9210 ESTERO PARK COMMONS BLVD STE 7, ESTERO, FL 33928-6395
(740) 412-6768
Mailing address
180 WICKLIFFE DR, NAPLES, FL 34110-1334
(740) 412-6768

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH20815
FL

Other

Enumeration date
11/15/2023
Last updated
11/15/2023
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