Individual
JENNA RUDO-STERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY-005339
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081666
—
AZ
Enumeration date
07/03/2018
Last updated
12/11/2023
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