Individual
SALENNA RUSSELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
1030 MINERS RD, SAINT JOSEPH, MI 49085-9625
(269) 408-1688
(269) 408-1692
Mailing address
146 MAURICE BLVD, RIO GRANDE, NJ 08242-1228
(609) 602-6597
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301016962
MI
Other
Enumeration date
12/02/2016
Last updated
12/02/2016
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