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General NPI Number Information
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NPI Number | 1740113521
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Entity Type | Individual
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Provider Name | MICHELLE RUST
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Gender | Female
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Dates
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Enumeration Date | 06/03/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 4 MOUNT PLEASANT AVE
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City | IPSWICH
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State | MA
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Zip | 01938-2156
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Country | US
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Telephone | 302-690-1966
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Fax |
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Provider Business Mailing Address
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Address Line | 4 MOUNT PLEASANT AVE
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City | IPSWICH
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State | MA
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Zip | 01938-2156
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 3993
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License Number State | MA
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