Individual
JULIA RUSSOMANNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MC, LPC
Contact information
Practice address
1351 N ALMA SCHOOL RD, 205, CHANDLER, AZ 85224-5936
(480) 491-7048
(480) 963-2036
Mailing address
1093 W GLENMERE DR, CHANDLER, AZ 85224-7581
(602) 750-4018
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-10273
AZ
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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