Provider Demographics
NPI:1093116618
Name:RUGGLES, KRISTEN ELIZABETH (OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:RUGGLES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ELIZABETH
Other - Last Name:HESSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:426 OAKHURST AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-5315
Mailing Address - Country:US
Mailing Address - Phone:269-370-8077
Mailing Address - Fax:269-743-2420
Practice Address - Street 1:3901 EMERALD DR STE D
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-7923
Practice Address - Country:US
Practice Address - Phone:269-443-2342
Practice Address - Fax:269-743-2420
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201008955225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics