Ruddock, Maxine A
Ruddock, Maxine A is an sole proprietor health care provider with primary practice located at 2511 Dora Ave , Tavares FL 32778-4977. She recently has 13 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Group Psychotherapy, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities, Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Family. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Ruddock, Maxine A can be contacted via phone (352) 508-5399.Contact Information
Primary practice address
2511 Dora Ave
Tavares FL 32778-4977
Phone: (352) 508-5399
Fax: (917) 677-7121
Website:
Health care specialties
Profile Details
| NPI number | 1205014461 |
|---|---|
| LBN Legal business name | Ruddock, Maxine A |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 8th, 2008 |
| Last updated | May 2nd, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205014461 | NPPES |
| Florida | MEDICAID | 008648900 | |
| Florida | MEDICAID | 004105100 |
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