Provider Demographics
NPI:1093809048
Name:NELSON-ABBOTT, RUTH A (PHD)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:A
Last Name:NELSON-ABBOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 WHEELER RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6549
Mailing Address - Country:US
Mailing Address - Phone:706-855-7784
Mailing Address - Fax:706-651-1090
Practice Address - Street 1:3633 WHEELER RD
Practice Address - Street 2:SUITE 110
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6549
Practice Address - Country:US
Practice Address - Phone:706-855-7784
Practice Address - Fax:706-651-1090
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001956103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling