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Individual

SPENCER RUDOLPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1320 MAIN ST STE 300, COLUMBIA, SC 29201-3266
(877) 418-2978
Mailing address
1320 MAIN ST STE 300, COLUMBIA, SC 29201-3266

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician
SC

Other

Enumeration date
05/20/2020
Last updated
11/09/2021
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