Doctor Name: | KIMBERLY G. RUTHERFORD |
NPI Number: | 1083929426 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 093 |
Business Practice Address: | 90 Beach St Saco, ME - 040722812 |
Business Phone Number: | 2072844505 |
Business Fax Number: | 2072845951 |
Mailing Address: | 90 Beach St, SACO |
State: | ME |
Postal Code: | 040722812 |
Phone Number: | 2072844505 |
Fax Number: | 2072845951 |
NPI Enumeration Date: | 08/10/2010 |
NPI Last Update Date: | 08/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 093 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |