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General NPI Number Information
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NPI Number | 1497377568
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Entity Type | Individual
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Provider Name | MARYSA RUSCETTI
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Gender | Female
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 5040 E. SHEA BLVD
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City | PHOENIX
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State | AZ
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Zip | 85028
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Country | US
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Telephone | 480-641-1165
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Fax |
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Provider Business Mailing Address
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Address Line | 335 N ALMA SCHOOL RD
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City | CHANDLER
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State | AZ
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Zip | 85224-4363
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Country | US
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Telephone | 480-641-1165
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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 |
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License Number State |
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