| Doctor Name: | DR. JASMINE RUTHERFORD |
| NPI Number: | 1356728992 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | PSY003814 |
| Business Practice Address: | 2101 Dutch Fork Rd Chapin, SC - 290367576 |
| Business Phone Number: | 9107429243 |
| Business Fax Number: | 8887461787 |
| Mailing Address: | Po Box 538622, ATLANTA |
| State: | GA |
| Postal Code: | 303538622 |
| Phone Number: | 9107429243 |
| Fax Number: | 8887461787 |
| NPI Enumeration Date: | 05/04/2015 |
| NPI Last Update Date: | 06/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY003814 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |