Michael Russo

NPI #1376944892 in Grafton, Ohio

Provider Information

NPI Number: 1376944892
Entity Type: Individual
Name: Michael Russo
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist - Clinical
Enumeration Date: Sep 16, 2014
Last Updated: Sep 16, 2014

Practice Location

Address: 2500 AVON BELDEN RD
City: Grafton
State: Ohio
ZIP Code: 44044-9802
Phone: (440) 748-5497

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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