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General NPI Number Information
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NPI Number | 1073948501
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Entity Type | Organization
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Legal Business Name | RUDBERG & RUDBERG, LLC
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 601 BROAD AVE
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City | BELLE VERNON
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State | PA
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Zip | 15012-1564
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Country | US
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Telephone | 412-427-7495
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Fax | 724-243-3161
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Provider Business Mailing Address
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Address Line | 9 COLUMBUS ST
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City | BELLE VERNON
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State | PA
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Zip | 15012-1309
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Country | US
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Telephone | 412-427-7495
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Fax | 724-243-3161
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Authorized Official
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Title or Position | PRESIDENT AND CFO
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Name | MR. RONALD L RUDBERG
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Credential | LPC
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Telephone | 412-427-7495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC000359
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License Number State | PA
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