Provider Demographics
NPI:1962578195
Name:RUGEL, ROBERT P (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:RUGEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11506 PURPLE BEECH DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1328
Mailing Address - Country:US
Mailing Address - Phone:703-476-8810
Mailing Address - Fax:703-476-6068
Practice Address - Street 1:11506 PURPLE BEECH DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1328
Practice Address - Country:US
Practice Address - Phone:703-476-8810
Practice Address - Fax:703-476-6068
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000657103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical