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Individual

MR. MICHAEL THOMAS RUPPERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
1518 E LANCASTER AVE, FORT WORTH, TX 76102-6774
(817) 255-7150
(817) 255-7130
Mailing address
1518 E LANCASTER AVE, FORT WORTH, TX 76102-6774
(817) 255-7150

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
62170
TX

Other

Enumeration date
02/23/2017
Last updated
02/23/2017
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