Individual
ASHLEY RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
23 SUTTON PL, CRANSTON, RI 02910-4122
(401) 787-4293
Mailing address
50 MAUDE ST, PROVIDENCE, RI 02908-4325
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/07/2017
Last updated
06/07/2017
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