Individual
ANN RUSSOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
790 NE 96TH ST, MIAMI SHORES, FL 33138-2520
(305) 613-1601
Mailing address
790 NE 96TH ST, MIAMI SHORES, FL 33138-2520
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW3701
FL
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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