Provider Demographics
NPI:1659356459
Name:RUFF, MARLENE JOYCE (MA)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:JOYCE
Last Name:RUFF
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 S MINNESOTA AVE
Mailing Address - Street 2:#201
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-4871
Mailing Address - Country:US
Mailing Address - Phone:605-334-7713
Mailing Address - Fax:605-334-5348
Practice Address - Street 1:625 S MINNESOTA AVE
Practice Address - Street 2:#201
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-4871
Practice Address - Country:US
Practice Address - Phone:605-334-7713
Practice Address - Fax:605-334-5348
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC699101YM0800X
SDLMFT1164QMHP106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4996167OtherBCBS