Provider Demographics
NPI:1518505700
Name:AULD, RUTH ETIOSA (MED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ETIOSA
Last Name:AULD
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 VOLVO PKWY
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-8123
Mailing Address - Country:US
Mailing Address - Phone:404-219-0614
Mailing Address - Fax:
Practice Address - Street 1:5100 JOHN D RYAN BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-3527
Practice Address - Country:US
Practice Address - Phone:210-677-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-18
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119311235Z00000X
VA2202009223235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist