Individual
MISS MELANIE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
26 SHENIPSIT LAKE RD, TOLLAND, CT 06084-2332
(860) 872-2999
Mailing address
1100 HARTFORD TPKE APT 661, VERNON, CT 06066-9409
(203) 671-8682
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005608
CT
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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