Mary Russo is a Counselor based in Marlton, NJ. Mary Russo practices in Marlton, NJ. The NPI Number for Mary Russo is 1639818388 and holds a License No. (New Jersey).
The current practice location address for Mary Russo is 925 Route 73 N Ste H, Marlton, NJ and can be reached out via phone at 609-713-8763.
Location: 925 Route 73 N Ste H, Marlton, NJ, 08053-1277
Provider Profile Details
NPI Number
1639818388
Provider Name
Mary Russo
Credential
Provider Entity Type
Individual
Gender
Female
Address
925 Route 73 N Ste H, Marlton, NJ, 08053-1277
Phone Number
609-713-8763
Fax Number
Provider Enumeration Date
06/01/2022
Last Update Date
03/10/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R94585277161805 | 01 | NJ | DRIVER LICENSE |
Provider Business Practice Location Address Details
Address
925 Route 73 N Ste H
City
State
Zip
08053-1277
Phone Number
609-713-8763
Fax Number
Provider Business Mailing Address Details
Address
925 Route 73 N Ste H
City
State
Zip
08053-1277
Phone Number
609-713-8763
Fax Number
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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