Individual
MARTHA KICKASOLA RUSTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 S PARKWAY ST, CAPE GIRARDEAU, MO 63703-7799
(270) 994-3249
Mailing address
281 FLAGSTONE DR, CAPE GIRARDEAU, MO 63701-8454
(270) 994-3249
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2020001245
MO
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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