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NPI Code Detail

MEDICARE: EMILLIE RUTKOWSKI RBT

MEDICARE: EMILLIE RUTKOWSKI RBT
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
1106S00000XBehavior TechnicianRBT-23-291373FL

General Provider Information

NPI Number : 1477325900
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILLIE RUTKOWSKI RBT
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number : 317-520-8200
Provider Business Practice Location Address
First Line : 3600 MACLAY BLVD S STE 100
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32312-1276
Country : US
Telephone Number : 850-706-5445
Fax Number : 317-520-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2023
Last Update Date : 10/27/2023

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Directions to “ EMILLIE RUTKOWSKI RBT” Practice Location

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