Provider Demographics
NPI:1003670795
Name:RUYLE, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:RUYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 SUTTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63143-3036
Mailing Address - Country:US
Mailing Address - Phone:314-246-0751
Mailing Address - Fax:314-754-9926
Practice Address - Street 1:2718 SUTTON BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63143-3036
Practice Address - Country:US
Practice Address - Phone:314-246-0751
Practice Address - Fax:314-754-9926
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015011128225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist