Mrs. Liza Raquel Rudolph
Clinical Psychologist
255 E Sunset Ln
West Lafayette
, Indiana 47906-2456
Mrs. Liza Raquel Rudolph
Clinical Psychologist
255 E Sunset Ln
West Lafayette
, Indiana 47906-2456
(765) 447-9659
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About
Features
Specialties
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Mrs. Liza Raquel Rudolph
- Po Box 3884
- West Lafayette, IN
- Zip : 47996-3884
- Fax : (765) 447-9659
- Phone : (765) 532-9084
Second Address
- Mrs. Liza Raquel Rudolph
- 255 E Sunset Ln
- West Lafayette, IN
- Zip : 47906-2456
- Fax : (765) 447-9659
- Phone : (765) 532-9084
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FAQs
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Is Mrs. Liza Raquel Rudolph a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | 200251030 | IN |
| Y | 103TC0700X | Clinical Psychologist | 200251030 | IN |
National Provider Identifier
| NPI | 1003863382 |
|---|---|
| Provider Name | Mrs. Liza Raquel Rudolph |
| First Address | West Lafayette, IN 47996-3884 |
| Second Address | West Lafayette, IN 47906-2456 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/05/2006 |
| Last Update Date | 05/05/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000378693 | BLUE CROSS/BLUE SHIELD (01) | IN |
| 200251030B | (05) | IN |
| 251277 | VALUE OPTIONS (01) | IN |
| 284435000 | MAGELLAN (01) | IN |
| S89659 | (02) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.