Diane Russo, CASAC
NPI #1205474640 in North Babylon, New York
Provider Information
- NPI Number
- 1205474640
- Entity Type
- Individual
- Name
- Diane Russo, CASAC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Credential
- CASAC
- Enumeration Date
- Dec 17, 2019
- Last Updated
- Nov 27, 2023
Practice Location
- Address
- 281 PHELPS LN
- City
- North Babylon
- State
- New York
- ZIP Code
- 11703-4005
- Phone
- (631) 422-7676
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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