Mary Kathleen Russo
Occupational Therapist - Physical Rehabilitation
3775 Country Ln
Brownsburg
, Indiana 46112-8375
Mary Kathleen Russo
Occupational Therapist - Physical Rehabilitation
3775 Country Ln
Brownsburg
, Indiana 46112-8375
(317) 858-9828
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About
Features
Specialties
- Occupational Therapist - Physical Rehabilitation
Languages spoken
- English
Location
First Address
- Mary Kathleen Russo
- 3775 Country Ln
- Brownsburg, IN
- Zip : 46112-8375
- Phone : (317) 858-9828
Second Address
- Mary Kathleen Russo
- 3775 Country Ln
- Brownsburg, IN
- Zip : 46112-8375
- Phone : (317) 858-9828
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 31003367A | IN |
National Provider Identifier
| NPI | 1003049230 |
|---|---|
| Provider Name | Mary Kathleen Russo |
| First Address | Brownsburg, IN 46112-8375 |
| Second Address | Brownsburg, IN 46112-8375 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/09/2009 |
| Last Update Date | 04/09/2009 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.