Individual
JONATHAN ROGER RUCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1015 DORSEY LN, LOUISVILLE, KY 40223-2612
(502) 263-3515
Mailing address
2322 THORNHILL RD, LOUISVILLE, KY 40222-6261
(504) 975-3130
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
253375
KY
Other
Enumeration date
09/24/2021
Last updated
09/24/2021
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