Individual
MRS. DEBORAH RUSSO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
27 SUNNYSIDE DR, MONTVALE, NJ 07645-1319
(201) 573-0560
Mailing address
27 SUNNYSIDE DR, MONTVALE, NJ 07645-1319
(201) 573-0560
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC00667300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5250590501
—
NJ
Enumeration date
01/24/2006
Last updated
07/08/2007
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