| Doctor Name: | PAULA K RUSSO |
| NPI Number: | 1013085943 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC |
| License Number: | 370 |
| Business Practice Address: | 41 Oak St. Douglas, MA - 015162215 |
| Business Phone Number: | 9782501560 |
| Business Fax Number: | 5084763051 |
| Mailing Address: | 41 Oak St., DOUGLAS |
| State: | MA |
| Postal Code: | 015162215 |
| Phone Number: | 9782501560 |
| Fax Number: | 5084763051 |
| NPI Enumeration Date: | 11/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 370 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |