Individual provider · Type 1 NPI

Nicole Russo

Addiction (Substance Use Disorder) Counselor · Philadelphia, PA

NPI number 1235647314 Active

Practice location

9815 Roosevelt Blvd
Philadelphia, PA 19114-1035

Call (616) 644-6464 Map

Mailing address

680 American Ave
King Of Prussia, PA 19406-4023

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1235647314

Nicole Russo's National Provider Identifier is 1235647314, issued on Jan 11, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Philadelphia, PA. The record was last updated on Jan 11, 2018.