Provider Demographics
NPI:1548599137
Name:ODUORI, RUTH W (MED)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:W
Last Name:ODUORI
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 E MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2611
Mailing Address - Country:US
Mailing Address - Phone:602-685-1940
Mailing Address - Fax:602-685-1944
Practice Address - Street 1:1110 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2611
Practice Address - Country:US
Practice Address - Phone:602-685-1940
Practice Address - Fax:602-685-1944
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health