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General NPI Number Information
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NPI Number | 1831528124
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Entity Type | Individual
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Provider Name | SUSAN ELIZABETH RUFFINI LBA
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Gender | Female
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Dates
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Enumeration Date | 11/06/2013
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 1796 S LAPEER RD
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City | LAKE ORION
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State | MI
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Zip | 48360-1443
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Country | US
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Telephone | 248-895-2047
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Fax |
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Provider Business Mailing Address
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Address Line | 4852 MEADOWBROOK LN
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City | LAKE ORION
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State | MI
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Zip | 48359-2037
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Country | US
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Telephone | 248-724-8792
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Fax |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-13-14122
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License Number State | MI
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