Individual
MISTY RUSKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, ICADC
Contact information
Practice address
106 E PARK ST STE 100, MCCALL, ID 83638-5064
(208) 405-5708
Mailing address
106 E PARK ST STE 100, MCCALL, ID 83638-5064
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11402
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46-5601304
—
ID
Enumeration date
08/20/2021
Last updated
08/20/2021
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