Individual
RUSTY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9532 E 16 FRONTAGE RD, ONALASKA, WI 54650-6739
(608) 783-0506
(608) 783-0242
Mailing address
9532 E 16 FRONTAGE RD, ONALASKA, WI 54650-6739
(608) 783-0506
(608) 783-0242
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21004-130
WI
Other
Enumeration date
10/29/2025
Last updated
10/29/2025
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