Healthcare Provider Details

I. General information

NPI: 1588433387
Provider Name (Legal Business Name): ARIA R RUGGIERO PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 ASHLEY AVE
CHARLESTON SC
29425-8908
US

IV. Provider business mailing address

67 PRESIDENT ST STE 1-SOUTH
CHARLESTON SC
29425-5712
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-1414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1819
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: