IndividualActive
Bon Rush, LSAA
NPI 1104670694 · Addiction (Substance Use Disorder) Counselor · Mescalero, NM
Provider details
- NPI number
- 1104670694
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Credential
- LSAA
- Sex
- Female
- Sole proprietor
- No
- License
- CTB-2023-0647 (NM)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
107 Sunset Loop
Mescalero, NM 88340
Phone: (575) 464-2827
Fax: (575) 464-4321
Approximate (ZIP-level) locationGet directions
Mailing address
212 Sunny Slope Dr
Ruidoso, NM 88345-7258
Registry dates
- Enumerated
- 2024-04-12
- Last updated
- 2024-04-12
- Certified
- 2024-04-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.