| NPI | 1578807236 | 
|---|---|
| Former Name | STEPHANIE L RUSH | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC010775) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA 010775) | 
| Enumeration Date | 2012-11-19 | 
| Last Update Date | 2023-06-20 |