Individual
LAURA D RUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
10913 70TH AVE N, SEMINOLE, FL 33776
(727) 458-2155
Mailing address
10913 70TH AVE N, SEMINOLE, FL 33776
(727) 458-2155
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT2517
FL
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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