Provider Demographics
NPI:1588859078
Name:POOLE, RONNI SPRUNG (LMFT)
Entity Type:Individual
Prefix:MS
First Name:RONNI
Middle Name:SPRUNG
Last Name:POOLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1942
Mailing Address - Country:US
Mailing Address - Phone:508-393-9899
Mailing Address - Fax:508-393-9480
Practice Address - Street 1:20 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1942
Practice Address - Country:US
Practice Address - Phone:508-393-9899
Practice Address - Fax:508-393-9480
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-08
Last Update Date:2007-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA621106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist