Individual
ELIZABETH RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
370 PORTLAND ST, YARMOUTH, ME 04096-8101
(207) 846-9021
Mailing address
224 E MAIN ST, YARMOUTH, ME 04096-6909
(207) 846-5041
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT690
ME
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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