Individual
ERIN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 CENTRE ST STE 6&7, SALEM, CT 06420-3844
(860) 949-2561
Mailing address
10 PHELPS RD, MARLBOROUGH, CT 06447-1227
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
6246
CT
Other
Enumeration date
09/10/2021
Last updated
10/10/2024
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