Provider Demographics
NPI:1063631364
Name:RUST, MARGARET A (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:A
Last Name:RUST
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 1:1349 RACE ST
Mailing Address - Street 2:# 5
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2063
Mailing Address - Country:US
Mailing Address - Phone:720-855-3868
Mailing Address - Fax:
Practice Address - Street 1:3035 W 25TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4635
Practice Address - Country:US
Practice Address - Phone:720-855-3868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO581103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical