Individual
JEREMY DANIEL RUDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC, CCM
Contact information
Practice address
7460 WARREN PKWY STE 100, FRISCO, TX 75034-4170
(214) 484-7748
Mailing address
5105 REED DR, THE COLONY, TX 75056-1240
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
64960
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
N/A
—
Enumeration date
09/07/2017
Last updated
09/07/2017
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