Organization
MICHAEL L RUPLEY PHD PC
Active
Other names
MICHIANA PSYCHOLOGICAL ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL L RUPLEY PHD HSPP PC (CLINICAL PSYCHOLOGIST)
(574) 256-2258
Entity
Organization
Contact information
Practice address
323 WEST 4TH STREET, MISHAWAKA, IN 46544-1913
(574) 256-2258
(574) 256-2266
Mailing address
323 WEST 4TH STREET, MISHAWAKA, IN 46544-1913
(574) 256-2258
(574) 256-2266
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20010350
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000214616
ANTHEM BLUE CROSS
IN
05
—
100089740
—
IN
05
—
100089740A
—
IN
Enumeration date
02/18/2008
Last updated
05/06/2011
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