Individual
TISZA RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC III
Contact information
Practice address
1250 N WILSON AVE, LOVELAND, CO 80537-4461
(970) 494-9870
Mailing address
125 CRESTRIDGE ST, FORT COLLINS, CO 80525-3934
(970) 494-9761
(970) 300-3120
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC.0006814
CO
Other
Enumeration date
02/25/2014
Last updated
02/25/2014
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