| Doctor Name: | JOHNETTE B RUDDELL |
| NPI Number: | 1154596195 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 3699 |
| Business Practice Address: | 7726 Us Hwy 165 Haven Rehabilitation Center Columbia, LA - 71418 |
| Business Phone Number: | 3186499826 |
| Business Fax Number: | 3186499827 |
| Mailing Address: | 7726 Us Hwy 165, Haven Rehabilitation Center COLUMBIA |
| State: | LA |
| Postal Code: | 71418 |
| Phone Number: | 3186499826 |
| Fax Number: | 3186499827 |
| NPI Enumeration Date: | 04/29/2008 |
| NPI Last Update Date: | 04/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 3699 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |