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Individual

MRS. ETHELYN RUDDELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
30230 N ROYAL OAK WAY, QUEEN CREEK, AZ 85243-4324
(480) 882-1737
(480) 882-1915
Mailing address
30230 N ROYAL OAK WAY, QUEEN CREEK, AZ 85243-4324
(480) 882-1737
(480) 882-1915

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2742
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
575532
AZ
Enumeration date
12/04/2006
Last updated
07/09/2007
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