Individual
AMANDA RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1701 E 15TH ST, PLANO, TX 75074-6436
(972) 693-4444
Mailing address
PO BOX 261742, PLANO, TX 75026-1742
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
74419
TX
Other
Enumeration date
04/26/2019
Last updated
06/11/2019
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