| Doctor Name: | MRS. RAEANNE LEE RUSTER |
| NPI Number: | 1972835247 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 6801087333 |
| Business Practice Address: | 109 S Jackson St Spring Lake, MI - 494562095 |
| Business Phone Number: | 6168442900 |
| Business Fax Number: | 6168441571 |
| Mailing Address: | 13642 Maple Valley Dr, COOPERSVILLE |
| State: | MI |
| Postal Code: | 494049691 |
| Phone Number: | 6168442900 |
| Fax Number: | 6168441571 |
| NPI Enumeration Date: | 02/11/2010 |
| NPI Last Update Date: | 10/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 6801087333 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |