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NPI Code Detail

MEDICARE: NICOLE RUPRICH LCDC III

MEDICARE: NICOLE RUPRICH LCDC III
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1871730622
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE RUPRICH LCDC III
Provider Business Mailing Address
First Line : 830 EZZARD CHARLES DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45214-2525
Country : US
Telephone Number : 513-381-6672
Fax Number :
Provider Business Practice Location Address
First Line : 830 EZZARD CHARLES DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45214-2525
Country : US
Telephone Number : 513-381-6672
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2009
Last Update Date : 09/04/2014

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