Jessica Dean Russo PSY.D.

NPI 1659401990 - Psychologist - 103TC0700X

NPI Details
NPI 1659401990
Gender Female
Enumeration Date 03/06/2007
Last Updated 02/24/2010
Entity Type Individual
Active Over 9 years ago
Practice Location
230 S. BROAD ST.
STE 600
PHILA PA, 19102-4121, US
Phone (215) 545-2748
Fax (215) 545-2749
Business Location
230 S. BROAD ST.
STE 600
PHILA PA, 19102-4121, US
Phone (215) 545-2748
Fax (215) 545-2749
Toxanomy
Taxonomy Code 103TC0700X
License State Pennsylvania
License Number PS015317
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According to our database, Dr. Jessica Dean Russo PSY.D. NPI is 1659401990, taxonomy code is 103TC0700X and license number is PS015317, license state is located at Pennsylvania. Jessica Dean Russo PSY.D. physically located at 230 S. Broad St., Phila PA, 19102-4121. NPI Number Jessica Dean Russo PSY.D. has the Individual type.

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1659401990 NPI number is provided on an as is basis without warranty of any kind. 1659401990 is maintained by the National Plan & Provider Enumeration System. The contents of Jessica Dean Russo PSY.D. are for informational purposes only.