| Doctor Name: | ELLEN RUDIKOFF |
| NPI Number: | 1336220326 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D., PSY.D. |
| License Number: | 4760 |
| Business Practice Address: | 35 Littlefield Rd Newton Centre, MA - 024593009 |
| Business Phone Number: | 6172440109 |
| Business Fax Number: | |
| Mailing Address: | 35 Littlefield Rd, NEWTON CENTRE |
| State: | MA |
| Postal Code: | 024593009 |
| Phone Number: | 6172440109 |
| Fax Number: | |
| NPI Enumeration Date: | 10/18/2006 |
| NPI Last Update Date: | 11/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 4760 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |