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Individual

RICHARD E RUHROLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D., HSPP

Contact information

Practice address
850 N HARRISON ST, WARSAW, IN 46580-3163
(574) 267-7169
(574) 269-3995
Mailing address
2621 E JEFFERSON ST, WARSAW, IN 46580-3880
(574) 267-7169
(574) 269-4185

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040225A
IN
103TC0700X
Clinical Psychologist
20040225A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200040223A
IN
05
200040230A
IN
Enumeration date
10/27/2005
Last updated
03/18/2014
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