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Individual

CHARLOTTE MARIE DISOTELL-RUSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
25046 COOPER AVE, CALCIUM, NY 13616-2166
(315) 807-8670
(315) 222-8670
Mailing address
25046 COOPER AVE, CALCIUM, NY 13616-2166
(315) 807-8670
(315) 222-7465

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
014535-01
NY

Other

Enumeration date
11/21/2022
Last updated
11/01/2024
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