Kevin Russo, BCBA, LABA

NPI #1740899665 in Waltham, Massachusetts

Provider Information

NPI Number: 1740899665
Entity Type: Individual
Name: Kevin Russo, BCBA, LABA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Analyst
Credential: BCBA, LABA
Enumeration Date: Jul 27, 2020
Last Updated: Jul 27, 2020

Practice Location

Address: 564 MAIN ST STE 209
City: Waltham
State: Massachusetts
ZIP Code: 02452-5568
Phone: (781) 736-7900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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