MEDICARE: JUDY S RUFUS

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	1041C0700X	Clinical Social Worker	003671	MO

General Provider Information

NPI Number	:	1932714011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY S RUFUS

Provider Business Mailing Address
First Line	:	9733 SAINT CHARLES ROCK RD
Second Line	:
City	:	BRECKENRIDGE HILLS
State	:	MO
Zip	:	63114-2625
Country	:	US
Telephone Number	:	314-423-7030
Fax Number	:

Provider Business Practice Location Address
First Line	:	9733 SAINT CHARLES ROCK RD
Second Line	:
City	:	BRECKENRIDGE HILLS
State	:	MO
Zip	:	63114-2625
Country	:	US
Telephone Number	:	314-423-7030
Fax Number	:

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

Provider Enumeration Date	:	09/15/2020
Last Update Date	:	09/15/2020

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Directions to “ JUDY S RUFUS ” Practice Location

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