Individual
MS. ANDREA RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
567 PLEASANT ST, BROCKTON, MA 02301-2507
(508) 838-1696
Mailing address
11 HILLBERG AVE, BROCKTON, MA 02301-6522
(508) 958-9441
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/06/2009
Last updated
05/06/2009
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