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Individual

JOSHUA LEE RUDOLPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MHA

Contact information

Practice address
1051 N 16TH ST STE B, MURRAY, KY 42071-8511
(270) 753-6622
(270) 753-9669
Mailing address
425 BROADWAY ST, PADUCAH, KY 42001-0713

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
07/31/2019
Last updated
07/31/2019
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