Healthcare Provider Details

I. General information

NPI: 1043562820
Provider Name (Legal Business Name): MONICA MAY RUGG M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2012
Last Update Date: 10/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 OTSEGO RD
WORCESTER MA
01609-1736
US

IV. Provider business mailing address

26 OTSEGO RD
WORCESTER MA
01609-1736
US

V. Phone/Fax

Practice location:
  • Phone: 508-404-8062
  • Fax:
Mailing address:
  • Phone: 508-404-8062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: