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Individual

AMY D RUCKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PEL

Contact information

Practice address
407 S EDWARDS ST, ALTAMONT, IL 62411-1799
(618) 483-5171
(618) 483-6793
Mailing address
407 S EDWARDS ST, ALTAMONT, IL 62411-1799
(618) 483-5171
(618) 483-6793

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
448350
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
448350
PEL
IL
Enumeration date
09/29/2020
Last updated
06/28/2023
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