MEDICARE: RONALD M ARUNDELL EDD

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	103TC0700X	Clinical Psychologist	4668	OH

General Provider Information

NPI Number	:	1831381151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD M ARUNDELL EDD

Provider Business Mailing Address
First Line	:	1433 AMBROSE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2521
Country	:	US
Telephone Number	:	513-542-1342
Fax Number	:

Provider Business Practice Location Address
First Line	:	1433 AMBROSE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2521
Country	:	US
Telephone Number	:	513-542-1342
Fax Number	:

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

Provider Enumeration Date	:	08/10/2007
Last Update Date	:	08/10/2007

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