Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | ||
Y | 103TC1900X | Counseling Psychologist |
NPI | 1114228004 |
---|---|
Provider Name | Dr. J F Rupert |
First Address | Jackson, OH 45640-0028 |
Second Address | Jackson, OH 45640-9282 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2010 |
Last Update Date | 27/10/2016 |