Doctor Name: | MARGUERITE RUPPENICKER |
NPI Number: | 1053760579 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH. D. |
License Number: | 3193 |
Business Practice Address: | 49 Sherwood Ter Basement Level Old Saybrook, CT - 064752123 |
Business Phone Number: | 8603889882 |
Business Fax Number: | 8603889882 |
Mailing Address: | Po Box 645, WESTBROOK |
State: | CT |
Postal Code: | 064980645 |
Phone Number: | 8603889882 |
Fax Number: | 8603889882 |
NPI Enumeration Date: | 06/06/2016 |
NPI Last Update Date: | 06/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 3193 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |