Individual
CHARLA ANN RUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
545 W SIERRA ST, PORTOLA, CA 96122-8615
(775) 848-8834
Mailing address
4600 KIETZKE LN, B114, RENO, NV 89502-5033
(775) 848-8834
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
274C
NV
Other
Enumeration date
04/11/2012
Last updated
07/17/2012
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