Mrs Liza Raquel Rudolph, PHD - Psychologist in West Lafayette, IN

Mrs Liza Raquel Rudolph, PHD is a Psychologist - Clinical based in West Lafayette, Indiana. Mrs Liza Raquel Rudolph is licensed to practice in Indiana (license number 200251030) and her current practice location is 255 E Sunset Ln, West Lafayette, Indiana. She can be reached at her office (for appointments etc.) via phone at (765) 532-9084.

NPI number for Mrs Liza Raquel Rudolph is 1003863382 and her current mailing address is Po Box 3884, West Lafayette, Indiana. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1003863382.

Contact Information

Mrs Liza Raquel Rudolph, PHD
255 E Sunset Ln,
West Lafayette, IN 47906-2456
(765) 532-9084
(765) 447-9659

Map and Direction




Healthcare Provider's Profile

Full NameMrs Liza Raquel Rudolph
GenderFemale
SpecialityPsychologist - Clinical
Location255 E Sunset Ln, West Lafayette, Indiana
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1003863382
  • Provider Enumeration Date: 05/30/2006
  • Last Update Date: 05/05/2016

Medical Identifiers

Medical identifiers for Mrs Liza Raquel Rudolph such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003863382NPI-NPPES
000000378693OtherINBLUE CROSS/BLUE SHIELD
251277OtherINVALUE OPTIONS
200251030BMedicaidIN
284435000OtherINMAGELLAN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 200251030 (Indiana)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Liza Raquel Rudolph is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Liza Raquel Rudolph, PHD
Po Box 3884,
West Lafayette, IN 47996-3884

Ph: (765) 532-9084
Mrs Liza Raquel Rudolph, PHD
255 E Sunset Ln,
West Lafayette, IN 47906-2456

Ph: (765) 532-9084

Reviews and Comments


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