Individual
ELLEN RUSSAKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
169 GREENWOOD AVE, APT A2, JENKINTOWN, PA 19046-2626
(215) 589-8929
Mailing address
169 GREENWOOD AVE, APT A2, JENKINTOWN, PA 19046-2626
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW018088
PA
Other
Enumeration date
04/08/2014
Last updated
04/08/2014
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