Healthcare Provider Details

I. General information

NPI: 1679897045
Provider Name (Legal Business Name): DAVID L RUNG MS COMMUNITY COUNSEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2010
Last Update Date: 03/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E. LA CROSSE ST JUNEAU COUNTY HUMAN SERVICES
MAUSTON WI
53948-2101
US

IV. Provider business mailing address

220 E. LA CROSSE ST JUNEAU COUNTY HUMAN SERVICES
MAUSTON WI
53948-2101
US

V. Phone/Fax

Practice location:
  • Phone: 608-847-2400
  • Fax: 608-847-9599
Mailing address:
  • Phone: 608-847-2400
  • Fax: 608-847-9599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: