Organization
DR. LAURIE FAIRALL-RUETER, LLC
Active
Other names
Laurie Fairall-Rueter
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURIE FAIRALL-RUETER PSY.D. (LICENSED PSYCHOLOGIST)
(904) 463-2284
Entity
Organization
Contact information
Practice address
4400 MARSH LANDING BLVD, SUITE 1, PONTE VEDRA BEACH, FL 32082-1287
(904) 463-2284
(904) 543-7755
Mailing address
4400 MARSH LANDING BLVD, SUITE 1, PONTE VEDRA BEACH, FL 32082-1287
(904) 463-2284
(904) 543-7755
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
36593
TX
103TC0700X
Clinical Psychologist
Primary
PY 7675
FL
103TC0700X
Clinical Psychologist
PY003739
GA
Other
Enumeration date
03/04/2010
Last updated
04/17/2014
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