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General NPI Number Information
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NPI Number | 1164626628
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Entity Type | Individual
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Provider Name | THUY T. RUDY MS, CASAC, LPC
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Gender | Female
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 154 WINTERGREEN RD
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City | BRANSON
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State | MO
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Zip | 65616-8850
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Country | US
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Telephone | 417-880-7736
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Fax | 417-882-4604
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Provider Business Mailing Address
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Address Line | 5209 S HONEYSUCKLE LN
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City | BATTLEFIELD
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State | MO
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Zip | 65619-8292
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Country | US
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Telephone | 417-881-7839
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Fax | 417-882-4604
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 |
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License Number State | MO
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