Provider Demographics
NPI:1053652008
Name:BUSHA, ROSE ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROSE ANNE
Middle Name:
Last Name:BUSHA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 2ND ST SE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401-1204
Mailing Address - Country:US
Mailing Address - Phone:319-364-5106
Mailing Address - Fax:
Practice Address - Street 1:101 2ND ST SE
Practice Address - Street 2:SUITE 700
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-1204
Practice Address - Country:US
Practice Address - Phone:319-364-5106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00180106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist