Matthew Gerrard Russo
NPI #1053087288 in Gainesville, Florida
Provider Information
- NPI Number
- 1053087288
- Entity Type
- Individual
- Name
- Matthew Gerrard Russo
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Aug 18, 2021
- Last Updated
- Aug 18, 2021
Practice Location
- Address
- 250 NW 76TH DR
- City
- Gainesville
- State
- Florida
- ZIP Code
- 32607-6668
- Phone
- (352) 505-6363
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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