Provider Information for 1750589909
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Ms. MARIA ANGELA RUSSO LCSW
Sex: Female
NPI: 1750589909
Last Updated: 2007-07-10
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1750589909 | ||||||||||||
| Enumeration Date | 2007-07-10 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 10001 W 32ND AVE WHEAT RIDGE, CO 80033-5601 United States Phone: 303-238-1231 | Fax: | ||||||||||||
| Primary Practice Address | 6340 W 38TH AVE # 704 WHEAT RIDGE, CO 80033-5001 United States Phone: 303-422-3231 | Fax: | ||||||||||||
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