Individual
DOROTHY M CRUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC
Contact information
Practice address
10610 MAIN ST STE 224, HAYWARD, WI 54843-6586
(715) 634-4806
(715) 634-3580
Mailing address
10610 MAIN ST STE 224, HAYWARD, WI 54843-6586
(715) 634-4806
(715) 634-3580
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15449
WI
Other
Enumeration date
06/15/2015
Last updated
07/09/2015
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