Individual
SARA JUDITH RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
78 WARREN AVE, CRANSTON, RI 02920-1516
(401) 954-0222
Mailing address
78 WARREN AVE, CRANSTON, RI 02920-1516
(401) 954-0222
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP01048
RI
Other
Enumeration date
06/22/2010
Last updated
06/22/2010
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