Individual
MS. REBECCA RUDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CADC LCPC
Contact information
Practice address
16255 HARTMAN RD, DAVIS, IL 61019-9201
(815) 354-0604
Mailing address
9792 REDFIELD, ROSCOE, IL 61073-7117
(815) 354-0604
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180.007114
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
180.007114
IL
101YM0800X
Mental Health Counselor
180.007114
IL
Other
Enumeration date
11/19/2009
Last updated
03/25/2025
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