Provider Demographics
NPI:1699744698
Name:RUBEL, NANCY L (PHD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:L
Last Name:RUBEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 OAKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44121-1667
Mailing Address - Country:US
Mailing Address - Phone:216-410-3667
Mailing Address - Fax:
Practice Address - Street 1:3659 GREEN RD STE 100
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5715
Practice Address - Country:US
Practice Address - Phone:216-462-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4557103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist