Provider Demographics
NPI:1518622216
Name:VANBUSKIRK, RIAN ELIZABETH
Entity Type:Individual
Prefix:
First Name:RIAN
Middle Name:ELIZABETH
Last Name:VANBUSKIRK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 E BROOMFIELD ST APT CC2
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-7009
Mailing Address - Country:US
Mailing Address - Phone:517-581-6116
Mailing Address - Fax:
Practice Address - Street 1:324 W CEDAR AVE
Practice Address - Street 2:
Practice Address - City:GLADWIN
Practice Address - State:MI
Practice Address - Zip Code:48624-2022
Practice Address - Country:US
Practice Address - Phone:517-375-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician