Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mason Daniel Russo

Individual provider Behavior Technician · NPI 1760269815

Mason Daniel Russo is a Behavior Technician in Jenison, Michigan. Registered with an NPI since 2023.

In the registry since
2023
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Practice location Address checks out

8413 Cottonwood Dr
Jenison, MI 49428-8327
Phone: (574) 387-4313
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1760269815
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 12, 2023
Last updated in NPPESSeptember 12, 2023
Certification dateSeptember 12, 2023
Mailing address215 Red Coach Dr, Mishawaka, IN 46545-8307

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