Healthcare Provider Details

I. General information

NPI: 1477660033
Provider Name (Legal Business Name): MARIANNE THERESE RUGGERI PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 JONES ROAD SUITE 1B
FALMOUTH MA
02540
US

IV. Provider business mailing address

184 JONES ROAD SUITE 1B
FALMOUTH MA
02540
US

V. Phone/Fax

Practice location:
  • Phone: 508-540-4542
  • Fax: 508-548-0981
Mailing address:
  • Phone: 508-540-4542
  • Fax: 508-548-0981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4697
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: