Individual
MRS. RAEANNE LEE RUSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
109 S JACKSON ST, SPRING LAKE, MI 49456-2095
(616) 844-2900
(616) 844-1571
Mailing address
13642 MAPLE VALLEY DR, COOPERSVILLE, MI 49404-9691
(616) 844-2900
(616) 844-1571
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6801087333
MI
Other
Enumeration date
02/11/2010
Last updated
10/26/2011
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