Individual
MR. MICHAEL BRUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
5436 PERU ST. APT. 5, PLATTSBURGH, NY 12901
(518) 563-3519
Mailing address
5436 PERU ST APT 5, PLATTSBURGH, NY 12901-3474
(518) 563-3519
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
142579861
NY
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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