Individual
MRS. ANNEMARIE RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
51 BUENA VISTA AVE, HAWTHORNE, NJ 07506-2904
(201) 788-7568
Mailing address
51 BUENA VISTA AVE, HAWTHORNE, NJ 07506-2904
(201) 788-7568
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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