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Individual

MR. LARRY L RUPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW

Contact information

Practice address
3040A WINDSOR CT, ELKHART, IN 46514-5555
(574) 262-1088
(574) 262-9516
Mailing address
3040A WINDSOR CT, ELKHART, IN 46514-5555
(574) 262-1088
(574) 262-9516

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004488A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200535020A
IN
Enumeration date
02/07/2006
Last updated
06/30/2008
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