Individual
STACY RUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
1310 E KINGSLEY ST STE D, SPRINGFIELD, MO 65804-7233
(417) 413-1407
Mailing address
5342 W PAGE ST, SPRINGFIELD, MO 65802-5940
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2024003555
MO
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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