| Doctor Name: | DR. RUSS A RASMUSSEN |
| NPI Number: | 1013926799 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY. D. |
| License Number: | 20040529 |
| Business Practice Address: | 1701 Library Blvd Suite E Greenwood, IN - 461421567 |
| Business Phone Number: | 3178895612 |
| Business Fax Number: | 3178895912 |
| Mailing Address: | 742 Ramblin Rd, GREENWOOD |
| State: | IN |
| Postal Code: | 461428351 |
| Phone Number: | 3178819476 |
| Fax Number: | 3178895912 |
| NPI Enumeration Date: | 08/05/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 20040529 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |