Individual
JESSICA RUDDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1905 S TOPAZ WAY STE 100, MERIDIAN, ID 83642-4477
(208) 518-0870
Mailing address
11 S BENEWAH DR, NAMPA, ID 83651-2427
(986) 910-9100
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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