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Individual

THEA RUSCH-RE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1805 W HEAVENLY CT, FLAGSTAFF, AZ 86001-2836
(928) 226-1563
Mailing address
1805 W HEAVENLY CT, FLAGSTAFF, AZ 86001-2836

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP9216
AZ

Other

Enumeration date
01/12/2015
Last updated
01/12/2015
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