Provider Demographics
NPI:1740318609
Name:RUFF, KIMBERLEY ANN (BS)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLEY
Middle Name:ANN
Last Name:RUFF
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-2102
Mailing Address - Country:US
Mailing Address - Phone:218-259-1947
Mailing Address - Fax:
Practice Address - Street 1:724 NW 3RD AVE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-2543
Practice Address - Country:US
Practice Address - Phone:218-259-1947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health