Provider Demographics
NPI:1427597624
Name:RUDD, HALEY MICHELLE (BA)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:MICHELLE
Last Name:RUDD
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-1964
Mailing Address - Country:US
Mailing Address - Phone:515-643-6500
Mailing Address - Fax:
Practice Address - Street 1:1409 CLARK ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1964
Practice Address - Country:US
Practice Address - Phone:515-643-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker