Individual
KIRSTEN DENISE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
707 N BROADWAY, BALTIMORE, MD 21205-1888
(443) 923-2900
Mailing address
707 N BROADWAY, BALTIMORE, MD 21205-1832
(443) 923-2900
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
06/12/2019
Last updated
06/10/2023
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