Provider Demographics
NPI:1336957802
Name:RUCKS, DEBRA ANN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:RUCKS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 BARBRAGALE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31705-9576
Mailing Address - Country:US
Mailing Address - Phone:229-886-6885
Mailing Address - Fax:
Practice Address - Street 1:929 BARBRAGALE AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31705-9576
Practice Address - Country:US
Practice Address - Phone:229-886-6885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW011844171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor