Individual
MS. STEPHANIE RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1715 E CEDAR ST STE 115, OLATHE, KS 66062-1791
(785) 764-3053
Mailing address
2631 PRAIRIE ELM DR, LAWRENCE, KS 66047-4211
(785) 764-3053
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8795
KS
Other
Enumeration date
11/11/2016
Last updated
11/11/2016
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