Provider Demographics
NPI:1326460825
Name:RUCKSTUHL, LIONEL E JR (PHD)
Entity Type:Individual
Prefix:MR
First Name:LIONEL
Middle Name:E
Last Name:RUCKSTUHL
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3380 GLACIER CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-6839
Mailing Address - Country:US
Mailing Address - Phone:775-787-7028
Mailing Address - Fax:877-738-0730
Practice Address - Street 1:1001 RIO VISTA DR
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406
Practice Address - Country:US
Practice Address - Phone:775-423-3634
Practice Address - Fax:775-423-2314
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVPY0462103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical