Individual
MS. JENNIFER RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 LINDSEY CIR, OLD BRIDGE, NJ 08857-2678
(732) 757-9661
Mailing address
12 LINDSEY CIR, OLD BRIDGE, NJ 08857-2678
(732) 757-9661
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00779900
NJ
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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