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Individual

DR. RUSS A RASMUSSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY. D.

Contact information

Practice address
1701 LIBRARY BLVD, SUITE E, GREENWOOD, IN 46142-1567
(317) 889-5612
(317) 889-5912
Mailing address
742 RAMBLIN RD, GREENWOOD, IN 46142-8351
(317) 881-9476
(317) 889-5912

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20040529
IN

Other

Enumeration date
08/05/2006
Last updated
07/09/2007
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