Individual
MS. JAN C RUSENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
435 OCEAN CREEK DR #2711, MYRTLE BEACH, SC 29572
(843) 267-5007
Mailing address
435 OCEAN CREEK DR APT 2711, MYRTLE BEACH, SC 29572-5720
(843) 267-5007
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
570719507
PRIVATE INSURANCE
SC
Enumeration date
01/27/2012
Last updated
01/27/2012
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