Individual
LISA B RUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1270 TURNER ST, CLEARWATER, FL 33756-5921
(727) 443-7641
Mailing address
4107 BADEN DR, HOLIDAY, FL 34691-3411
(727) 457-4146
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
16355
FL
Other
Enumeration date
12/11/2018
Last updated
12/11/2018
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