Individual
DESTINY ALLURE RUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6331 INDUCON DR E, SANBORN, NY 14132-9016
(716) 250-1860
Mailing address
8205 MAIN ST STE 14, WILLIAMSVILLE, NY 14221-6054
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
125055-01
NY
Other
Enumeration date
09/27/2024
Last updated
09/27/2024
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