Provider Demographics
NPI:1508927138
Name:MATHERS, RUTHLYN ELIZABETH (MS-SLP-CCC)
Entity Type:Individual
Prefix:MS
First Name:RUTHLYN
Middle Name:ELIZABETH
Last Name:MATHERS
Suffix:
Gender:F
Credentials:MS-SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13707 COLGATE WAY APT 1233
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4893
Mailing Address - Country:US
Mailing Address - Phone:302-397-4452
Mailing Address - Fax:
Practice Address - Street 1:13707 COLGATE WAY APT 1233
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4893
Practice Address - Country:US
Practice Address - Phone:302-397-4452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist