Provider Demographics
NPI:1013006295
Name:RUBALOW, LOUISE L (LPC)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:L
Last Name:RUBALOW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 SPRINGDALE RD
Mailing Address - Street 2:SUITE #150
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2763
Mailing Address - Country:US
Mailing Address - Phone:856-424-1333
Mailing Address - Fax:856-424-7384
Practice Address - Street 1:1301 SPRINGDALE RD
Practice Address - Street 2:SUITE #150
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2763
Practice Address - Country:US
Practice Address - Phone:856-424-1333
Practice Address - Fax:856-424-7384
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC000626101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional