Individual
AMANDA ILYSE RUDDERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1218 W CLAY ST, RICHMOND, VA 23220-2218
(804) 546-9836
Mailing address
1218 W CLAY ST, RICHMOND, VA 23220-2218
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904019894
VA
Other
Enumeration date
07/13/2026
Last updated
07/13/2026
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