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Individual

MR. EDWARD B RUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
610 WAMPANOAG TRL, RIVERSIDE, RI 02915-1504
(401) 274-2500
Mailing address
610 WAMPANOAG TRL, RIVERSIDE, RI 02915-1504
(401) 431-9870

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
CSW00528
RI
1041C0700X
Clinical Social Worker
Primary
ISW02158
RI

Other

Enumeration date
12/19/2008
Last updated
02/13/2012
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