Individual provider · Type 1 NPI

Nicole Russo

Mental Health Counselor · Grants Pass, OR

NPI number 1992133490 Active

Practice location

715 SW Ramsey Ave
Grants Pass, OR 97527-5500

Call (541) 956-5579 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1992133490

Nicole Russo's National Provider Identifier is 1992133490, issued on Oct 18, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Grants Pass, OR. The record was last updated on Oct 18, 2013.