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General NPI Number Information
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NPI Number | 1477568806
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Entity Type | Organization
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Legal Business Name | MARGUERITE RUPPENICKER LLC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 06/18/2012
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Provider Practice Location Address
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Address Line | 49 SHERWOOD TER
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City | OLD SAYBROOK
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State | CT
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Zip | 06475-2123
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Country | US
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Telephone | 860-388-9882
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Fax | 860-388-9882
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Provider Business Mailing Address
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Address Line | PO BOX 645
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City | WESTBROOK
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State | CT
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Zip | 06498-0645
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Country | US
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Telephone | 860-388-9882
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Fax | 860-388-9882
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. MARGUERITE R. A. RUPPENICKER
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Credential | PH.D.
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Telephone | 860-388-9882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 003193
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License Number State | CT
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