Healthcare Provider Details

I. General information

NPI: 1225303597
Provider Name (Legal Business Name): BECKI RUGGLES LPC, M. ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 03/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27995 ROCHESTER RD
RICHLAND MO
65556-8216
US

IV. Provider business mailing address

27995 ROCHESTER RD
RICHLAND MO
65556-8216
US

V. Phone/Fax

Practice location:
  • Phone: 573-855-6857
  • Fax: 573-765-4350
Mailing address:
  • Phone: 573-855-6857
  • Fax: 573-765-4350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2011016800
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2011016800
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: