Ruderstaller, Thomas

Ruderstaller, Thomas is an individual health care provider with primary practice located at 2120 S Mcclintock Dr Ste. 105, Tempe AZ 85282-2692. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Ruderstaller, Thomas can be contacted via phone (480) 804-0326.

Contact Information

Primary practice address
2120 S Mcclintock Dr Ste. 105 Tempe AZ 85282-2692
Phone: (480) 804-0326
Fax: (480) 302-7884
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LAC-14239 Arizona
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC-15817 Arizona

Profile Details

NPI number 1043693096
LBN Legal business name Ruderstaller, Thomas
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2015
Last updated Jul 23rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043693096 NPPES
Arizona MEDICAID 069063

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