Individual
MICHELLE ANN RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-MHSP TEMP
Contact information
Practice address
210 COLONIAL HEIGHTS RD, KINGSPORT, TN 37663-2205
(423) 430-9687
Mailing address
1084 W OAKLAND AVE APT 739, JOHNSON CITY, TN 37604-2571
(520) 401-5943
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8070
TN
Other
Enumeration date
11/06/2025
Last updated
11/06/2025
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