Provider Demographics
NPI:1972757839
Name:RUBLE, CHARLA NICOLE (BA)
Entity Type:Individual
Prefix:MISS
First Name:CHARLA
Middle Name:NICOLE
Last Name:RUBLE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:607B S POLK ST
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-3968
Mailing Address - Country:US
Mailing Address - Phone:931-461-1368
Mailing Address - Fax:931-461-1372
Practice Address - Street 1:607B S POLK ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-3968
Practice Address - Country:US
Practice Address - Phone:931-461-1368
Practice Address - Fax:931-461-1372
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)