Provider Demographics
NPI:1114604964
Name:TEETERS, RUTH LYNN (ED)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:LYNN
Last Name:TEETERS
Suffix:
Gender:F
Credentials:ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1925
Mailing Address - Country:US
Mailing Address - Phone:740-708-4882
Mailing Address - Fax:
Practice Address - Street 1:18 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1925
Practice Address - Country:US
Practice Address - Phone:740-708-4882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHXU1008299103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool