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Organization

RUTTENBERG AUTISM CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TAMEKA NICOLE RODGERS MHA (DIRECTOR OF COMPLIANCE)
(215) 220-2137
Entity
Organization

Contact information

Practice address
1740 WALTON RD, BLUE BELL, PA 19422-2342
(484) 567-3310
(267) 531-0005
Mailing address
1740 WALTON RD, BLUE BELL, PA 19422-2342
(484) 567-3310
(267) 531-0005

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
103TC0700X
Clinical Psychologist
Primary
103TM1800X
Intellectual & Developmental Disabilities Psychologist
103TP0016X
Prescribing (Medical) Psychologist

Other

Enumeration date
01/20/2015
Last updated
01/20/2015
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