Provider Demographics
NPI:1598033631
Name:RUTH C. ROWBOTHAM, PSY.D., LLC
Entity Type:Organization
Organization Name:RUTH C. ROWBOTHAM, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROWBOTHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:617-429-1423
Mailing Address - Street 1:225 WATER ST STE A115
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4060
Mailing Address - Country:US
Mailing Address - Phone:617-650-2896
Mailing Address - Fax:
Practice Address - Street 1:225 WATER ST STE A115
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4060
Practice Address - Country:US
Practice Address - Phone:617-650-2896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-04
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9372103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty