Provider Demographics
NPI:1811006620
Name:RUSNAK, REBECCA J (AUD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:RUSNAK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:J
Other - Last Name:BRUTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1809 AZTEC DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-4401
Mailing Address - Country:US
Mailing Address - Phone:501-612-0901
Mailing Address - Fax:
Practice Address - Street 1:2305 SPRINGHILL RD
Practice Address - Street 2:SUITE 8
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72019-7552
Practice Address - Country:US
Practice Address - Phone:501-943-3214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR271231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist