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General NPI Number Information
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NPI Number | 1396145009
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Entity Type | Individual
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Provider Name | AMBER RUSCH
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Gender | Female
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Dates
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Enumeration Date | 08/29/2014
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 502 MAIN ST W STE 305
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City | ASHLAND
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State | WI
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Zip | 54806-1579
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Country | US
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Telephone | 715-682-5209
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Fax |
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Provider Business Mailing Address
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Address Line | 7665 US HIGHWAY 2
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City | IRON RIVER
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State | WI
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Zip | 54847-4690
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Country | US
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Telephone | 715-372-5001
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1573-26
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 16629-130
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License Number State | WI
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