Individual
BON J RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
107 SUNSET LOOP, MESCALERO, NM 88340
(575) 464-2827
(575) 464-4321
Mailing address
212 SUNNY SLOPE DR, RUIDOSO, NM 88345-7258
(940) 231-4929
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2023-0647
NM
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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