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General NPI Number Information
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NPI Number | 1225704679
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Entity Type | Organization
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Legal Business Name | CHRISTINE RUSSO THERAPY PLLC
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 202 E SPOKANE FALLS BLVD STE 302
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City | SPOKANE
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State | WA
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Zip | 99202-1612
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Country | US
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Telephone | 509-855-9373
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Fax | 509-757-2221
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Provider Business Mailing Address
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Address Line | 4511 S SHERI CT
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City | SPOKANE
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State | WA
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Zip | 99223-4456
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER/ THERAPIST
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Name | CHRISTINE RUSSO
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Credential | MSW, LICSW, LMHC
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Telephone | 509-855-9373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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