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Individual

MRS. TARA R RULLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
3734 7TH AVE, SUITE 12, KENOSHA, WI 53140-5525
(262) 654-9370
(262) 654-9379
Mailing address
37790 89TH PL, TWIN LAKES, WI 53181-9168
(262) 537-3877
(262) 537-3718

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
06/09/2009
Last updated
06/09/2009
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