MEDICARE: ANNA KATHRYN RUGGIERI

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	106E00000X	Assistant Behavior Analyst		SC

General Provider Information

NPI Number	:	1841034758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA KATHRYN RUGGIERI

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:	864-729-0402
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 LAURENS ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3931
Country	:	US
Telephone Number	:	864-729-0402
Fax Number	:

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

Provider Enumeration Date	:	06/24/2024
Last Update Date	:	06/24/2024

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