Provider Demographics
NPI:1689046351
Name:GATES, RUTH ANN (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ANN
Last Name:GATES
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6562 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-1151
Mailing Address - Country:US
Mailing Address - Phone:910-987-4941
Mailing Address - Fax:
Practice Address - Street 1:6562 COUNTRYSIDE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-1151
Practice Address - Country:US
Practice Address - Phone:910-987-4941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2337235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist