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1013431683
ETHAN RUCKER
CHICAGO, IL
NPI
1013431683
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IL 178013109)
Enumeration Date
2017-07-26
Last Update Date
2022-07-21
Business Address
ETHAN RUCKER LPC
4875 N PAULINA ST APT 2A
CHICAGO, IL 60640-4176
Phone number: 904-599-6248
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Mailing Address
ETHAN RUCKER LPC
4875 N PAULINA ST APT 2A
CHICAGO, IL 60640-4176
Phone number: 904-599-6248
Copy
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