Individual
MRS. GAY L RUDDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LLL-SLP
Contact information
Practice address
1606 N 7TH ST, TERRE HAUTE, IN 47804-2780
(812) 238-7362
Mailing address
1606 N 7TH ST, TERRE HAUTE, IN 47804-2780
(812) 238-7362
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22001794A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22001794A
STATE LICENSE NUMBER
IN
Enumeration date
01/05/2011
Last updated
01/05/2011
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