Provider Demographics
NPI:1992205645
Name:RUDMANN, CHRISTOPHER JOSEPH (CDCA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:RUDMANN
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 CENTER ST APT 3
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-1501
Mailing Address - Country:US
Mailing Address - Phone:740-442-3999
Mailing Address - Fax:
Practice Address - Street 1:214 S 4TH ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1610
Practice Address - Country:US
Practice Address - Phone:740-532-3767
Practice Address - Fax:740-532-3385
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.120178101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)