Individual
MS. DIANA G RUCHELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
260 GRAYSON RD., JEWISH FAMILY SERVICE OF TIDEWATER, INC., VIRGINIA BEACH, VA 23462-4345
(757) 459-4640
(757) 459-4643
Mailing address
260 GRAYSON RD., JEWISH FAMILY SERVICE OF TIDEWATER, INC., VIRGINIA BEACH, VA 23462-4345
(757) 459-4640
(757) 459-4643
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904001533
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063435
BLUE CROSS
VA
05
—
8907684
—
VA
Enumeration date
07/12/2006
Last updated
07/08/2007
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