Provider Demographics
NPI:1467754655
Name:WEBB, RUTH HELEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:HELEN
Last Name:WEBB
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12826 HICKORY CT
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-7476
Mailing Address - Country:US
Mailing Address - Phone:515-371-9783
Mailing Address - Fax:515-221-0213
Practice Address - Street 1:14225 UNIVERSITY AVE
Practice Address - Street 2:SUITE 114A
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8294
Practice Address - Country:US
Practice Address - Phone:515-371-9783
Practice Address - Fax:515-225-6680
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001197103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1467754655Medicaid