Individual
DEANNA RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., OTR/L
Contact information
Practice address
551 PARK AVE, SUITE 4, SCOTCH PLAINS, NJ 07076-1767
(908) 380-7715
Mailing address
85 FISHER DR, HILLSBOROUGH, NJ 08844-5264
(908) 448-7069
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
46TR00764900
NJ
Other
Enumeration date
01/29/2017
Last updated
01/29/2017
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