Provider Information for 1568930808
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TIERRA TYNIECE RUSHING LCSW
Sex: Female
NPI: 1568930808
Last Updated: 2018-11-05
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1568930808 | ||||||||
| Enumeration Date | 2018-11-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2623 S SEACREST BLVD STE 65 BOYNTON BEACH, FL 33435-7541 United States Phone: 561-806-6835 | Fax: | ||||||||
| Primary Practice Address | 2623 S SEACREST BLVD STE 65 BOYNTON BEACH, FL 33435-7541 United States Phone: 561-806-6835 | Fax: | ||||||||
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