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General NPI Number Information
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NPI Number | 1699210625
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Entity Type | Individual
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Provider Name | LAKESHA RUISE RRT-NPS,CPFT
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Gender | Female
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Dates
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Enumeration Date | 12/29/2016
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 17 BELMONT AVE
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City | BRATTLEBORO
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State | VT
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Zip | 05301-7601
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Country | US
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Telephone | 443-852-4891
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Fax |
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Provider Business Mailing Address
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Address Line | 3672 COOLIDGE HWY
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City | GUILFORD
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State | VT
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Zip | 05301-8626
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Country | US
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Telephone | 443-852-4891
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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 | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 122.0134878
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License Number State | VT
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