Individual
VIKKI L RULLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHP, CADC I
Contact information
Practice address
2577 NE COURTNEY DRIVE, BEND, OR 97701
(541) 322-7500
(541) 322-7565
Mailing address
2577 NE COURTNEY DRIVE, BEND, OR 97701
(541) 322-7500
(541) 322-7565
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11-06-66
OR
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C3419
OR
Other
Enumeration date
12/05/2006
Last updated
05/19/2014
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