Individual
KELLY ANNE RUDOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
115 S MCCORMICK ST, PRESCOTT, AZ 86303-4738
(928) 756-0662
Mailing address
5649 N BRONCO LN, PRESCOTT VALLEY, AZ 86314-5856
(516) 592-7369
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-23118
AZ
Other
Enumeration date
02/28/2022
Last updated
06/12/2024
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