Provider Demographics
NPI:1194365494
Name:SMITH, RUTHANN (IECE)
Entity Type:Individual
Prefix:MRS
First Name:RUTHANN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:IECE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 REBECCA ANN CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-4333
Mailing Address - Country:US
Mailing Address - Phone:270-312-4379
Mailing Address - Fax:
Practice Address - Street 1:398 REBECCA ANN CT
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-4333
Practice Address - Country:US
Practice Address - Phone:270-312-4379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist