Provider Demographics
NPI:1114103843
Name:POOLER, RUTH A (LMFT)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:A
Last Name:POOLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 W. 9TH ST. N
Mailing Address - Street 2:SUITE B
Mailing Address - City:LADYSMITH
Mailing Address - State:WI
Mailing Address - Zip Code:54848
Mailing Address - Country:US
Mailing Address - Phone:715-532-9771
Mailing Address - Fax:715-532-9774
Practice Address - Street 1:804 W. 9TH ST. N
Practice Address - Street 2:SUITE B
Practice Address - City:LADYSMITH
Practice Address - State:WI
Practice Address - Zip Code:54848
Practice Address - Country:US
Practice Address - Phone:715-532-9771
Practice Address - Fax:715-532-9774
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI781-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist