Provider Demographics
NPI:1164626628
Name:RUDY, THUY T (MS, CASAC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:THUY
Middle Name:T
Last Name:RUDY
Suffix:
Gender:F
Credentials:MS, CASAC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5209 S HONEYSUCKLE LN
Mailing Address - Street 2:
Mailing Address - City:BATTLEFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65619-8292
Mailing Address - Country:US
Mailing Address - Phone:417-881-7839
Mailing Address - Fax:417-882-4604
Practice Address - Street 1:154 WINTERGREEN RD
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-8850
Practice Address - Country:US
Practice Address - Phone:417-880-7736
Practice Address - Fax:417-882-4604
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional