Individual
JONATHAN RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2703 SE G ST STE 2, BENTONVILLE, AR 72712-3740
(479) 368-2911
(479) 391-5254
Mailing address
13767 PELLA LN, NEOSHO, MO 64850-8781
(479) 368-2911
(479) 391-5254
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P2404003
AR
Other
Enumeration date
11/15/2022
Last updated
09/21/2025
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