Provider Demographics
NPI:1568918910
Name:RUETHER, GINA ELIZABETH (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:ELIZABETH
Last Name:RUETHER
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 W PRIDE DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-1207
Mailing Address - Country:US
Mailing Address - Phone:636-231-2550
Mailing Address - Fax:636-231-2555
Practice Address - Street 1:840 W PRIDE DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-1207
Practice Address - Country:US
Practice Address - Phone:636-231-2550
Practice Address - Fax:636-231-2555
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001024781235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist