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General NPI Number Information
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NPI Number | 1346457363
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Entity Type | Individual
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Provider Name | MICHAEL D RUBATT LLMSW
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Gender | Male
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 103 WEST U.S. 2
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City | WAKEFIELD
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State | MI
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Zip | 49968
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Country | US
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Telephone | 906-229-6120
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Fax | 906-229-6191
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Provider Business Mailing Address
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Address Line | 200 W COOLIDGE AVE
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City | IRONWOOD
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State | MI
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Zip | 49938-1104
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Country | US
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Telephone | 906-932-1467
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Fax | 906-229-6191
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6801087411
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License Number State | MI
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