Individual
AMANDA RUSSO-FOLCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 GOLD STAR BLVD, WORCESTER, MA 01606-2738
(508) 571-1615
Mailing address
2 OHARA CIR, WORCESTER, MA 01604-1446
(508) 981-1204
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13432
MA
Other
Enumeration date
08/19/2020
Last updated
10/04/2022
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