Individual
DR. JEREMY RUCKSTAETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LPC, NCC
Contact information
Practice address
1023 EXECUTIVE PARKWAY DR STE 10, SAINT LOUIS, MO 63141-6323
(314) 469-5522
Mailing address
15638 SUMMER LAKE DR, CHESTERFIELD, MO 63017-5136
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2011033777
MO
Other
Enumeration date
06/12/2020
Last updated
06/12/2020
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