Individual
PROF. CARMEN VINCENT RUSSONIELLO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
BELK BUILDING SUITE 2501, EAST CAROLINA UNIVERSITY, GREENVILLE, NC 27858
(252) 328-0024
Mailing address
311 KING GEORGE RD, GREENVILLE, NC 27858-5617
(252) 353-8674
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3454
NC
Other
Enumeration date
05/13/2009
Last updated
05/13/2009
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