person
Diane Marie Russo
Mental Health Counselor in New York, New York
NPI 1568022333

Diane Marie Russo is a Mental Health Counselor based in Staten Island, NY and is specialized in Mental Health. Diane Marie Russo practices in New York, NY. The NPI Number for Diane Marie Russo is 1568022333 and holds a License No. 100854-01 (New York).

The current practice location address for Diane Marie Russo is 2090 Adam Clayton Powell Jr Blvd, New York, NY and can be reached out via phone at 212-663-9300.

Location: 2090 Adam Clayton Powell Jr Blvd, New York, NY, 10306-3946
person
Provider Profile Details
NPI Number
1568022333
Provider Name
Diane Marie Russo
Credential
Provider Entity Type
Individual
Gender
Female
Address
2090 Adam Clayton Powell Jr Blvd, New York, NY, 10306-3946
Phone Number
212-663-9300
Fax Number
Provider Enumeration Date
06/14/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2090 Adam Clayton Powell Jr Blvd
City
State
Zip
10027-4990
Phone Number
212-663-9300
Fax Number
person
Provider Business Mailing Address Details
Address
2090 Adam Clayton Powell Jr Blvd
City
State
Zip
10027-4990
Phone Number
212-663-9300
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
100854-01 (New York)
Definition
Definition to come...
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