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Individual

MS. HEATHER LYNN MUSHRUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCIT, SAC-IT

Contact information

Practice address
1000 N LYNNDALE DR, SUITE C, APPLETON, WI 54914-3056
(920) 735-9010
(920) 735-9050
Mailing address
1000 N LYNNDALE DR, SUITE C, APPLETON, WI 54914-3056
(920) 735-9010
(920) 735-9050

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17766-130
WI
101YM0800X
Mental Health Counselor
Primary
3163-226
WI

Other

Enumeration date
04/28/2016
Last updated
08/04/2016
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