Individual
JEFFREY RUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
351 MEADOW LN, PROVIDENCE, UT 84332-9818
(435) 757-3562
Mailing address
351 MEADOW LN, PROVIDENCE, UT 84332-9818
(435) 757-3562
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5180207-2501
UT
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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