Individual
JANICE SANFORD-RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 44118-4819
(216) 932-2800
Mailing address
5708 CHESTNUT RD, INDEPENDENCE, OH 44131-3371
(216) 573-6946
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0004339
OH
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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