Mallory Russo

NPI #1376362236 in Sturgis, Michigan

Provider Information

NPI Number: 1376362236
Entity Type: Individual
Name: Mallory Russo
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Analyst
Enumeration Date: Oct 8, 2024
Last Updated: Oct 8, 2024

Practice Location

Address: 921 BROADUS ST STE B
City: Sturgis
State: Michigan
ZIP Code: 49091-2403
Phone: (833) 624-6385

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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