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NPI 1376629527

NPI 1376629527 : KIM A RUSCH MSE, LPC : CRIVITZ, WI

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General NPI Number Information
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    NPI Number           |    1376629527
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    Entity Type          |    Individual 
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    Provider Name        |    KIM A RUSCH MSE, LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/31/2006
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    Last Update Date     |    06/04/2025
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Provider Practice Location Address
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    Address Line         |    519 N US HIGHWAY 141 
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    City                 |    CRIVITZ
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    State                |    WI
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    Zip                  |    54114-1639
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    Country              |    US
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    Telephone            |    715-330-3738
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    Fax                  |    715-430-2243
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Provider Business Mailing Address
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    Address Line         |    W9994 GETAWAY LN 
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    City                 |    CRIVITZ
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    State                |    WI
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    Zip                  |    54114-8236
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    Country              |    US
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    Telephone            |    920-321-4002
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    Fax                  |    
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    3255125
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    License Number State |    WI
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