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General NPI Number Information
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NPI Number | 1225254592
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Entity Type | Individual
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Provider Name | THERESA MARIAN RUSCIO L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9035 WADSWORTH PKWY 2750
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City | WESTMINSTER
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State | CO
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Zip | 80021-8634
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Country | US
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Telephone | 303-464-8105
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Fax | 303-420-6517
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Provider Business Mailing Address
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Address Line | 11217 GRAY ST
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City | WESTMINSTER
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State | CO
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Zip | 80020-6874
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Country | US
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Telephone | 303-464-8105
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Fax | 303-420-6517
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 992072
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License Number State | CO
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