Provider Demographics
NPI:1053027649
Name:RUGGIERO, RHIANNON SKYE (RBT)
Entity type:Individual
Prefix:
First Name:RHIANNON
Middle Name:SKYE
Last Name:RUGGIERO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 LASALLE AVE
Mailing Address - Street 2:
Mailing Address - City:WENONAH
Mailing Address - State:NJ
Mailing Address - Zip Code:08090-1426
Mailing Address - Country:US
Mailing Address - Phone:856-723-5178
Mailing Address - Fax:
Practice Address - Street 1:500 CLEMENTS BRIDGE RD STE 2
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08007-1812
Practice Address - Country:US
Practice Address - Phone:856-617-0486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22-243902103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst