MEDICARE: DR. RONALD RUFF SCHOOL PSYCHOLOGIST

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	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1548933997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD RUFF SCHOOL PSYCHOLOGIST

Provider Business Mailing Address
First Line	:	3757 E COVEY LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-5004
Country	:	US
Telephone Number	:	708-205-7189
Fax Number	:

Provider Business Practice Location Address
First Line	:	3757 E COVEY LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-5004
Country	:	US
Telephone Number	:	708-205-7189
Fax Number	:

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

Provider Enumeration Date	:	07/30/2021
Last Update Date	:	07/30/2021

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