Individual
DR. MANDY PHILLIPS RUDDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5150 STILESBORO RD NW, SUITE 100, KENNESAW, GA 30152-7744
(404) 680-3032
Mailing address
5150 STILESBORO RD NW, SUITE 100, KENNESAW, GA 30152-7744
(404) 680-3032
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003837
GA
Other
Enumeration date
02/01/2012
Last updated
02/01/2012
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