Individual
DONNA RUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5721 S CEDAR AVE, BROKEN ARROW, OK 74011-4814
(918) 455-7771
Mailing address
5721 S CEDAR AVE, BROKEN ARROW, OK 74011-4814
(918) 455-7771
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1668
OK
Other
Enumeration date
08/15/2007
Last updated
12/20/2012
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