Individual
MRS. ANDREA M RAUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA-ECSE
Contact information
Practice address
421 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 705-5415
Mailing address
308B E OAK ST, SHELLEY, ID 83274-1186
(208) 406-4468
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
03/01/2016
Last updated
03/01/2016
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