Individual
PATRICIA DIANE RUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2202 BRYAN ST, MELBOURNE, FL 32901-5958
(321) 409-2136
(321) 409-2140
Mailing address
2202 BRYAN ST, MELBOURNE, FL 32901-5958
(321) 409-2136
(321) 409-2140
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7685904 00
—
FL
Enumeration date
08/10/2007
Last updated
01/17/2013
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