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1417013723
ANN M RUDOLPH
PORT JEFFERSON, NY
NPI
1417013723
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY R037202-1)
Enumeration Date
2006-12-29
Last Update Date
2007-07-08
Business Address
-- ANN M RUDOLPH L-CSW-R
1000 MAIN ST
PORT JEFFERSON, NY 11777-2250
Phone number: 631-331-4458
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Mailing Address
-- ANN M RUDOLPH L-CSW-R
1000 MAIN ST
PORT JEFFERSON, NY 11777-2250
Phone number: 631-331-4458
Copy
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