Provider Demographics
NPI:1366582181
Name:RUTELL, AARON LEE (MS)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:LEE
Last Name:RUTELL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13520 KEEFE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-3359
Mailing Address - Country:US
Mailing Address - Phone:414-793-4396
Mailing Address - Fax:414-270-0339
Practice Address - Street 1:400 E WISCONSIN AVE STE 22OA
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4469
Practice Address - Country:US
Practice Address - Phone:414-793-4396
Practice Address - Fax:414-270-0339
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3362-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3362-125OtherLICENSED PROF. COUNSELOR