MEDICARE: DEBRA J RUGGIERO PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	294	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083728182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA J RUGGIERO PHD

Provider Business Mailing Address
First Line	:	715 MAIN ST
Second Line	:	SUITE C
City	:	STEVENSVILLE
State	:	MT
Zip	:	59870-2846
Country	:	US
Telephone Number	:	406-777-3800
Fax Number	:	406-777-0581

Provider Business Practice Location Address
First Line	:	715 MAIN ST
Second Line	:	SUITE C
City	:	STEVENSVILLE
State	:	MT
Zip	:	59870-2846
Country	:	US
Telephone Number	:	406-777-3800
Fax Number	:	406-777-0581

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	10/09/2007

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