Individual
LORA ELIZABETH RUSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
213 MIDDLEBURY ST, GOSHEN, IN 46528-2956
(574) 534-3300
(574) 534-5412
Mailing address
213 MIDDLEBURY ST, GOSHEN, IN 46528-2956
(574) 534-3300
(574) 534-5412
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006327A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34006327A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
03/20/2014
Last updated
03/20/2014
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