Individual
JESSICA NICOLE RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC, NCC, RPT
Contact information
Practice address
2300 MCKOWN DR, NORMAN, OK 73072-6678
(405) 321-3600
Mailing address
2300 MCKOWN DR, NORMAN, OK 73072-6678
(405) 321-3600
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
76423
TX
101YP2500X
Professional Counselor
Primary
11486
OK
Other
Enumeration date
08/15/2018
Last updated
09/12/2023
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