Provider Demographics
NPI:1477903318
Name:JENKINS, RUBY CATHERINE (MA)
Entity Type:Individual
Prefix:MRS
First Name:RUBY
Middle Name:CATHERINE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:GA
Mailing Address - Zip Code:31064-1016
Mailing Address - Country:US
Mailing Address - Phone:706-476-9001
Mailing Address - Fax:
Practice Address - Street 1:108 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:GA
Practice Address - Zip Code:31064-1016
Practice Address - Country:US
Practice Address - Phone:706-476-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health