Joan Carol Russo is a Clinical in Oconomowoc, Wisconsin. Joan Carol Russo practices all healthcare services and medical treatments related to Clinical. The NPI Number for Joan Carol Russo is 1225037575. The last update date is 2014-07-07.
Joan Carol Russo's current location address is W340n6509 Breezy Point Rd, Oconomowoc, Wisconsin. You can contact this provider via phone number 2624909114. The mailing address for Joan Carol Russo is W340n6509 Breezy Point Rd, Oconomowoc, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Joan Carol Russo |
|---|---|
| Address | W340n6509 Breezy Point Rd, Oconomowoc, Wisconsin |
| Phone Number | 2624909114 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1225037575 |
|---|---|
| Provider Enumeration Date | 2005-07-19 |
| Last Updated Date | 2014-07-07 |
Provider Mailing Address Detail
| Address | W340n6509 Breezy Point Rd |
|---|---|
| City | Oconomowoc |
| State | Wisconsin (WI) |
| Post Code | 530665132 |
| Phone Number | 2624909114 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 1169 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 39114000 | WI | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Joan Carol Russo by the Centers for Medicare & Medicaid Services?
The Joan Carol Russo has been assigned the NPI (National Provider Identifier) 1225037575 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Joan Carol Russo's facilities are situated?
The facilities of Joan Carol Russo are physically located at the following address: W340N6509 Breezy Point Rd, Oconomowoc, WI, 530665132.
What is Joan Carol Russo's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Joan Carol Russo is Clinical, and the taxonomy code that categorizes this field of expertise is 103Tc0700X.
When was the Joan Carol Russo's 1225037575 issued?
The Joan Carol Russo's 1225037575 was issued on 2005-07-19.
As of what date were the details pertaining to Joan Carol Russo last refreshed?
The information related to the Joan Carol Russo, including its address, specialty, and other relevant details, was last updated on 2014-07-07.