Kelly Gravino Russell, LICSW
NPI #1336244763 in Ipswich, Massachusetts
Provider Information
- NPI Number
- 1336244763
- Entity Type
- Individual
- Name
- Kelly Gravino Russell, LICSW
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker - Clinical
- Credential
- LICSW
- Enumeration Date
- Sep 13, 2006
- Last Updated
- Jun 29, 2020
Practice Location
- Address
- 16 BUSH HILL RD
- City
- Ipswich
- State
- Massachusetts
- ZIP Code
- 01938-1642
- Phone
- (978) 810-8397
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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