Individual
MRS. MICHELLE K RUSBOLDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5300 MEMORIAL DR, TWO RIVERS, WI 54241-3923
(920) 793-7420
Mailing address
5300 MEMORIAL DR, TWO RIVERS, WI 54241-3923
(920) 793-7420
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
127961-121
WI
Other
Enumeration date
12/04/2015
Last updated
12/08/2021
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