Provider Demographics
NPI:1013539618
Name:RUBDI, LAURIE FALBE (LBSW, QMHP,QIDP,CMHP)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:FALBE
Last Name:RUBDI
Suffix:
Gender:F
Credentials:LBSW, QMHP,QIDP,CMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 HARRIS AVE
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48763-9681
Mailing Address - Country:US
Mailing Address - Phone:989-362-8636
Mailing Address - Fax:
Practice Address - Street 1:15393 15 MILE RD APT 303
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-2197
Practice Address - Country:US
Practice Address - Phone:586-202-9169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802071744104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker