Provider Information for 1518504208
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AMANDA DAWN RUSCO MS LPC
Sex: Female
NPI: 1518504208
Last Updated: 2023-07-13
Certification Date: 2023-07-13
Certification Date: 2023-07-13
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1518504208 | ||||||||
| Enumeration Date | 2019-12-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 20016 E 62ND PL AURORA, CO 80019-2208 United States Phone: 405-436-9275 | Fax: | ||||||||
| Primary Practice Address | 20016 E 62ND PL AURORA, CO 80019-2208 United States Phone: 405-436-9275 | Fax: | ||||||||
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