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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JOAN CAROL RUSSO, PH.D.

Active Sole Proprietor

JOAN CAROL RUSSO, PH.D. is a Clinical Psychologist healthcare provider located in OCONOMOWOC, Wisconsin. NPI 1225037575 is currently active in the NPPES registry. Verify at CMS.

Clinical Psychologist · OCONOMOWOC, WI

Registration Details

NPI Number
1225037575
Provider Type
Individual
Gender
Female
NPI Issued
Jul 19, 2005 (21.034968060126 yrs)
Last Updated
Jul 7, 2014
License
1169 (WI)
Sole Proprietor
Yes

Practice Information

Address
W340N6509 BREEZY POINT RD
OCONOMOWOC, WI, 530665132
Browse WI providers · Browse ZIP 53066
Phone
2624909114
Primary Specialty
Clinical Psychologist
103TC0700X

Other Clinical Psychologist Providers in OCONOMOWOC, WI

Name Credential NPI
DR. MIA NUNEZ PHD 1649866096
SAMUEL CARES PHD, LP 1366331423
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.