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Individual

MARY RUST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
600 E MASON ST, SUITE 401, MILWAUKEE, WI 53202-3870
(414) 224-3737
(414) 224-3725
Mailing address
600 E MASON ST, SUITE 401, MILWAUKEE, WI 53202-3870
(414) 224-3737
(414) 224-3725

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4122-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40933700
WI
Enumeration date
07/18/2006
Last updated
07/08/2007
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