Provider Demographics
NPI:1376525758
Name:HENNESSY, RUTHINE A (PHD)
Entity Type:Individual
Prefix:DR
First Name:RUTHINE
Middle Name:A
Last Name:HENNESSY
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 1:4301 GARTH RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3153
Mailing Address - Country:US
Mailing Address - Phone:281-420-8400
Mailing Address - Fax:281-420-8480
Practice Address - Street 1:4301 GARTH RD
Practice Address - Street 2:SUITE 400
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3153
Practice Address - Country:US
Practice Address - Phone:281-420-8400
Practice Address - Fax:281-420-8480
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10689101YP2500X
TX000936-031517106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist