Most Relevant Information
Provider Data
| NPI Number: | 1003049230 |
| Provider Name: | MARY KATHLEEN RUSSO MS OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225XP0019X |
| Specialty: | Occupational Therapist |
| License Number: | 31003367A |
Most Important Dates
| Enumeration Date: | 09/04/2009 |
| Last Updated: | 09/04/2009 |
Provider Practice Location
3775 COUNTRY LN
BROWNSBURG
IN
461128375
Practice Location Phone/Fax
| Phone: | 3178589828 |
| Fax: |
Provider Mailing Location
3775 COUNTRY LN
BROWNSBURG
IN
461128375
Provider Mailing Phone/Fax
| Phone: | 3178589828 |
| Fax: |