Individual
MS. ANN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9587 RICKSHAW ST, LAS VEGAS, NV 89123-7618
(562) 253-2572
Mailing address
9587 RICKSHAW ST, LAS VEGAS, NV 89123-7618
(562) 253-2572
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/12/2011
Last updated
12/27/2013
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