Provider Demographics
NPI:1134838162
Name:RUEFFERT, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:RUEFFERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 HUNTINGTON AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-1448
Mailing Address - Country:US
Mailing Address - Phone:703-768-6240
Mailing Address - Fax:
Practice Address - Street 1:2560 HUNTINGTON AVE STE 302
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-1448
Practice Address - Country:US
Practice Address - Phone:703-768-6240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health